Healthcare Provider Details

I. General information

NPI: 1881192664
Provider Name (Legal Business Name): BRIGHTER HOPE WELLNESS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2018
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 TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number
License Number StateNULL
# 6
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL
# 7
Primary TaxonomyN
Taxonomy Code103TH0004X
TaxonomyHealth Psychologist
License Number
License Number StateNULL
# 8
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

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