Healthcare Provider Details

I. General information

NPI: 1619859360
Provider Name (Legal Business Name): RECLAIM AND RESTORE HEALING COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2025
Last Update Date: 07/23/2025
Certification Date: 07/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 CRAIGTOWN ROAD SUITE 103
PORT DEPOSIT MD
21904
US

IV. Provider business mailing address

2120 EMMORTON PARK RD STE E
EDGEWOOD MD
21040-1066
US

V. Phone/Fax

Practice location:
  • Phone: 443-402-1925
  • Fax: 213-289-8532
Mailing address:
  • Phone: 443-402-1925
  • Fax: 213-289-8532

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: ALANA MARIE O'NEILL
Title or Position: PRESIDENT
Credential: LGPC
Phone: 410-823-5357