Healthcare Provider Details

I. General information

NPI: 1174471585
Provider Name (Legal Business Name): WHITTLEWELL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2026
Last Update Date: 03/20/2026
Certification Date: 03/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6340 SECURITY BLVD. SUITE 100 PMD #1286
BALTIMORE MD
21207
US

IV. Provider business mailing address

6340 SECURITY BLVD SUITE 100 PMD #1286
BALTIMORE MD
21207
US

V. Phone/Fax

Practice location:
  • Phone: 202-780-8811
  • Fax:
Mailing address:
  • Phone: 202-780-8811
  • 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: TAMARA WHITTLETON
Title or Position: SOCIAL WORKER
Credential: LCSW-C
Phone: 443-900-5265