Healthcare Provider Details

I. General information

NPI: 1164388468
Provider Name (Legal Business Name): THE HEALING STORM HOLISTIC WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/30/2025
Last Update Date: 12/30/2025
Certification Date: 12/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 TOLL HOUSE AVE STE A3
FREDERICK MD
21701-6110
US

IV. Provider business mailing address

801 TOLL HOUSE AVE STE A3
FREDERICK MD
21701-6110
US

V. Phone/Fax

Practice location:
  • Phone: 240-394-6046
  • Fax:
Mailing address:
  • Phone: 240-394-6046
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: MS. CHANIN STORM
Title or Position: OWNER/PRACTITIONER
Credential: LMT
Phone: 240-394-6046