Healthcare Provider Details

I. General information

NPI: 1851216600
Provider Name (Legal Business Name): THE COLLECTIVE NP CLINIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

517 BENFIELD RD STE 100
SEVERNA PARK MD
21146-2527
US

IV. Provider business mailing address

517 BENFIELD RD STE 100
SEVERNA PARK MD
21146-2527
US

V. Phone/Fax

Practice location:
  • Phone: 443-494-8924
  • Fax: 410-824-5240
Mailing address:
  • Phone: 443-494-8924
  • Fax: 410-824-5240

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ASHLEY FENTON
Title or Position: OWNER/NURSE PRACTITIONER
Credential: DNP, PMHNP-BC, FNP-C
Phone: 410-562-5061