Healthcare Provider Details

I. General information

NPI: 1639008766
Provider Name (Legal Business Name): ACHIEVING WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2513 THORNBERRY DR
EDGEWOOD MD
21040-2829
US

IV. Provider business mailing address

2513 THORNBERRY DR
EDGEWOOD MD
21040-2829
US

V. Phone/Fax

Practice location:
  • Phone: 443-570-4837
  • Fax: 201-603-1819
Mailing address:
  • Phone: 443-570-4837
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARK A BERNARD
Title or Position: OWNER
Credential: LCSW-C
Phone: 443-570-4837