Healthcare Provider Details

I. General information

NPI: 1053256644
Provider Name (Legal Business Name): BEACH BALANCE HOLISTIC CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2026
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8510 OLIVER ST
NEW CARROLLTON MD
20784-2836
US

IV. Provider business mailing address

8507 OXON HILL RD STE 200
FORT WASHINGTON MD
20744-4774
US

V. Phone/Fax

Practice location:
  • Phone: 301-741-7705
  • Fax:
Mailing address:
  • Phone: 301-741-7705
  • 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: MONIQUE BERLIN BEACH
Title or Position: OWNER
Credential: LCSW-C
Phone: 301-741-7705