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General NPI Number Information
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NPI Number | 1558275925
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Entity Type | Organization
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Legal Business Name | WELLNESS SOURCE LLC
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Dates
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Enumeration Date | 10/01/2026
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Last Update Date | 10/01/2026
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Provider Practice Location Address
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Address Line | 4301 GARDEN CITY DR STE 304
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City | HYATTSVILLE
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State | MD
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Zip | 20785-6105
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Country | US
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Telephone | 301-235-0060
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Fax |
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Provider Business Mailing Address
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Address Line | 4301 GARDEN CITY DR STE 304
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City | HYATTSVILLE
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State | MD
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Zip | 20785-6105
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Country | US
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Telephone | 301-235-0060
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. MARSHALEE GEORGE
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Credential |
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Telephone | 301-235-0060
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State | NULL
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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 | NULL
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State | NULL
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Taxonomy #4
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number |
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License Number State | NULL
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Taxonomy #5
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State | NULL
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Taxonomy #6
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State | NULL
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Taxonomy #7
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State | NULL
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Taxonomy #8
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State | NULL
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Taxonomy #9
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number |
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License Number State | NULL
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Taxonomy #10
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State | NULL
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