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General NPI Number Information
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NPI Number | 1003418989
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Entity Type | Organization
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Legal Business Name | EMPAS WELLNESS CENTER, LLC
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Dates
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Enumeration Date | 11/15/2020
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Last Update Date | 11/15/2020
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Provider Practice Location Address
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Address Line | 7213 CHAPPARAL DR
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City | DISTRICT HEIGHTS
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State | MD
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Zip | 20747-1772
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Country | US
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Telephone | 301-388-6086
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Fax |
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Provider Business Mailing Address
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Address Line | 4244 SUITLAND RD APT 103
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City | SUITLAND
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State | MD
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Zip | 20746-2054
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHARLES SMALLEY
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Credential |
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Telephone | 301-388-6086
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 102X00000X
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Taxonomy Name | Poetry Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 225600000X
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Taxonomy Name | Dance Therapist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 225A00000X
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Taxonomy Name | Music Therapist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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