Healthcare Provider Details

I. General information

NPI: 1225733694
Provider Name (Legal Business Name): HOLISTIC HEALTH- COUNSELING & COACHING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2023
Last Update Date: 04/04/2023
Certification Date: 01/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2453 MARYLAND AVE
BALTIMORE MD
21218-5018
US

IV. Provider business mailing address

2453 MARYLAND AVE
BALTIMORE MD
21218-5018
US

V. Phone/Fax

Practice location:
  • Phone: 410-804-8000
  • Fax:
Mailing address:
  • Phone: 410-804-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. MELVIN JEWS
Title or Position: OWNER / THERAPIST
Credential: LCPC
Phone: 410-804-5800