Healthcare Provider Details

I. General information

NPI: 1255286944
Provider Name (Legal Business Name): GLOW & CO MENTAL HEALTH SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2026
Last Update Date: 02/27/2026
Certification Date: 02/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 POST OFFICE RD STE 302
WALDORF MD
20602-3704
US

IV. Provider business mailing address

50 POST OFFICE RD STE 302
WALDORF MD
20602-3704
US

V. Phone/Fax

Practice location:
  • Phone: 301-200-9958
  • Fax:
Mailing address:
  • Phone: 301-200-9958
  • Fax:

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: GLORIA JOHNSTON
Title or Position: OWNER OF ENTITY
Credential:
Phone: 301-200-9958