Healthcare Provider Details

I. General information

NPI: 1447189527
Provider Name (Legal Business Name): SERVICEBERRY CARE COLLECTIVE
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

245 W PATRICK ST
FREDERICK MD
21701-6934
US

IV. Provider business mailing address

146 W ALL SAINTS ST
FREDERICK MD
21701-5520
US

V. Phone/Fax

Practice location:
  • Phone: 202-368-3018
  • Fax:
Mailing address:
  • Phone: 202-368-3018
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: OLIVIA NUSS
Title or Position: LICENSED CLINICAL SOCIAL WORKER
Credential: LCSW-C
Phone: 202-368-3018