Healthcare Provider Details

I. General information

NPI: 1750915492
Provider Name (Legal Business Name): ART OF BECOMING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2020
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1612 PROFESSIONAL BLVD STE A
CROFTON MD
21114-2049
US

IV. Provider business mailing address

1612 PROFESSIONAL BLVD STE A
CROFTON MD
21114-2049
US

V. Phone/Fax

Practice location:
  • Phone: 301-875-5429
  • Fax:
Mailing address:
  • Phone: 301-875-5429
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. JAMICE A. HOLLEY
Title or Position: COUNSELOR/THERAPIST
Credential: LCPC
Phone: 240-599-6255