Healthcare Provider Details

I. General information

NPI: 1659987543
Provider Name (Legal Business Name): WELLBEING DESIGNED, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2020
Last Update Date: 08/30/2024
Certification Date: 08/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8894 STANFORD BLVD STE 103
COLUMBIA MD
21045-5161
US

IV. Provider business mailing address

8894 STANFORD BLVD STE 103
COLUMBIA MD
21045-5161
US

V. Phone/Fax

Practice location:
  • Phone: 240-997-8512
  • Fax: 410-741-3689
Mailing address:
  • Phone:
  • Fax: 410-741-3689

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. CLAUDETTE KIRKMAN
Title or Position: OWNER/PSYCHOLOGIST
Credential:
Phone: 240-997-8512