Healthcare Provider Details
I. General information
NPI: 1255277901
Provider Name (Legal Business Name): WILDFLOWER COUNSELING & CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/26/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4814 PORTSMOUTH RD
ELLICOTT CITY MD
21042-6284
US
IV. Provider business mailing address
4814 PORTSMOUTH RD
ELLICOTT CITY MD
21042-6284
US
V. Phone/Fax
- Phone: 410-428-3130
- Fax:
- Phone: 410-428-3130
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
PAULA
A
DA SILVA-DEBREW
Title or Position: OWNER/PSYCHOTHERAPIST
Credential: LCPC
Phone: 410-428-3130