Healthcare Provider Details

I. General information

NPI: 1538701859
Provider Name (Legal Business Name): FAMILY HEALTH AND WELLNESS CLINIC, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2019
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8101 SANDY SPRING RD, SUITE 300 #1020
LAUREL MD
20707-3596
US

IV. Provider business mailing address

8101 SANDY SPRING RD STE 300
LAUREL MD
20707-3596
US

V. Phone/Fax

Practice location:
  • Phone: 816-301-4135
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. AMANDA FELIX
Title or Position: OWNER
Credential: DNP, PMHNP-BC, AGNP
Phone: 402-484-4226