Healthcare Provider Details

I. General information

NPI: 1598629842
Provider Name (Legal Business Name): ATHELAS INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8805 COLUMBIA 100 PKWY STE 105
COLUMBIA MD
21045-2357
US

IV. Provider business mailing address

8805 COLUMBIA 100 PKWY STE 105
COLUMBIA MD
21045-2357
US

V. Phone/Fax

Practice location:
  • Phone: 410-964-1241
  • Fax:
Mailing address:
  • Phone: 410-964-1241
  • 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 Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DANIELLE HARRINGTON
Title or Position: DIRECTOR OF INTEGRATED HEALTH & WEL
Credential:
Phone: 410-964-1241