Healthcare Provider Details

I. General information

NPI: 1457161226
Provider Name (Legal Business Name): REFINED INTEGRATIVE PSYCHIATRY & WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2025
Last Update Date: 10/23/2025
Certification Date: 10/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5018 DORSEY HALL DR STE 104
ELLICOTT CITY MD
21042-7856
US

IV. Provider business mailing address

8005 HIGH CASTLE RD
ELLICOTT CITY MD
21043-5517
US

V. Phone/Fax

Practice location:
  • Phone: 410-213-5233
  • Fax: 410-213-5233
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. CALEB LEE
Title or Position: PSYCHIATRIC NURSE PRACTITIONER
Credential: OMD, PMHNP
Phone: 410-213-5233