Healthcare Provider Details

I. General information

NPI: 1033934419
Provider Name (Legal Business Name): BREATH OF FRESH AIR, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2024
Last Update Date: 03/11/2026
Certification Date: 03/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10001 DEREKWOOD LN STE 204
LANHAM MD
20706-4864
US

IV. Provider business mailing address

2010 COOPER POINT CT
ODENTON MD
21113-2918
US

V. Phone/Fax

Practice location:
  • Phone: 301-613-1038
  • Fax: 410-695-2998
Mailing address:
  • Phone: 301-613-1038
  • Fax: 410-695-2998

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY DOWNING
Title or Position: CEO
Credential: LCPC
Phone: 301-613-1038