Healthcare Provider Details

I. General information

NPI: 1164370953
Provider Name (Legal Business Name): TRUE TRANSFORMATION WELLNESS GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2026
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 N HAVEN ST STE N
BALTIMORE MD
21224-1612
US

IV. Provider business mailing address

1327 N EDEN ST
BALTIMORE MD
21213-2824
US

V. Phone/Fax

Practice location:
  • Phone: 410-609-4471
  • Fax:
Mailing address:
  • Phone: 443-707-0833
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: BROOKE STANLEY
Title or Position: PMHNP-BC
Credential: NP
Phone: 443-707-0833