Healthcare Provider Details

I. General information

NPI: 1063211530
Provider Name (Legal Business Name): TREE OF LIFE MENTAL HEALTH CTR, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2025
Last Update Date: 03/10/2025
Certification Date: 03/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11720 BELTSVILLE DR STE 500
BELTSVILLE MD
20705-3139
US

IV. Provider business mailing address

10 MUSICMASTER CT
SILVER SPRING MD
20904-6847
US

V. Phone/Fax

Practice location:
  • Phone: 240-621-0785
  • Fax:
Mailing address:
  • Phone: 240-621-0785
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: SHARELLE A HILL
Title or Position: CEO/CLINICAL DIRECTOR
Credential: LCSW-C
Phone: 240-621-0785