Healthcare Provider Details

I. General information

NPI: 1750291316
Provider Name (Legal Business Name): HALYARD BEHAVIORAL HEALTH & WELLNESS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2415 MARYLAND AVE
BALTIMORE MD
21218-5017
US

IV. Provider business mailing address

2415 MARYLAND AVE
BALTIMORE MD
21218-5017
US

V. Phone/Fax

Practice location:
  • Phone: 240-718-8274
  • Fax: 410-810-2176
Mailing address:
  • Phone: 240-718-8274
  • Fax: 410-810-2176

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LC1500X
TaxonomyCommunity Health Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: TASHICA MONIQUE HALYARD
Title or Position: DIRECTOR
Credential: LCPC, CAC-AD
Phone: 281-508-3604