Healthcare Provider Details

I. General information

NPI: 1003675059
Provider Name (Legal Business Name): HOLISTIC THERAPIES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2024
Last Update Date: 03/13/2024
Certification Date: 03/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

860 HIGH ST
CHESTERTOWN MD
21620-3909
US

IV. Provider business mailing address

9540 FAIRLEE RD
CHESTERTOWN MD
21620-3817
US

V. Phone/Fax

Practice location:
  • Phone: 443-480-7392
  • Fax: 410-559-1123
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code163WP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Registered Nurse
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number
License Number StateNULL

VIII. Authorized Official

Name: MS. BRANDY BARRETT
Title or Position: PSYCHIATRIC MENTAL HEALTH NP
Credential: PMHNP-BC
Phone: 443-480-7392