Healthcare Provider Details

I. General information

NPI: 1134045735
Provider Name (Legal Business Name): STREGA THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 SULGRAVE AVE
BALTIMORE MD
21209-3654
US

IV. Provider business mailing address

4404 BAYONNE AVE
BALTIMORE MD
21206-2806
US

V. Phone/Fax

Practice location:
  • Phone: 410-216-4514
  • Fax:
Mailing address:
  • Phone: 410-216-4514
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: KERIANNE BROWN
Title or Position: OWNER
Credential: LCSW-C
Phone: 410-216-4514