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General NPI Number Information
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NPI Number | 1144183047
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Entity Type | Organization
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Legal Business Name | CAREVINA BEHAVIORAL HEALTH LLC
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Dates
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Enumeration Date | 12/08/2025
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 46940 S SHANGRI LA DR STE 100-13
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City | LEXINGTON PARK
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State | MD
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Zip | 20653-1037
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Country | US
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Telephone | 240-510-4216
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Fax |
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Provider Business Mailing Address
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Address Line | 46940 S SHANGRI LA DR STE 100-13
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City | LEXINGTON PARK
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State | MD
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Zip | 20653-1037
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Country | US
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Telephone | 240-510-4216
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Fax |
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Authorized Official
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Title or Position | MD
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Name | ADEBOLA AYANDA-WILSON
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Credential |
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Telephone | 240-510-4216
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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