Healthcare Provider Details

I. General information

NPI: 1013568385
Provider Name (Legal Business Name): BRIGHTER HOPE WELLNESS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2019
Last Update Date: 10/31/2021
Certification Date: 10/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6100 DAYLONG LN STE 103
CLARKSVILLE MD
21029-1631
US

IV. Provider business mailing address

6100 DAYLONG LN STE 103
CLARKSVILLE MD
21029-1631
US

V. Phone/Fax

Practice location:
  • Phone: 410-531-8100
  • Fax: 410-531-8900
Mailing address:
  • Phone: 410-531-8100
  • Fax: 410-531-8900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. CINDY TERLONGE GRAHAM
Title or Position: OWNER/LICENSED PSYCHOLOGIST
Credential: PHD
Phone: 443-672-8478