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General NPI Number Information
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NPI Number | 1710542691
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Entity Type | Organization
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Legal Business Name | ESSENTIALS TO WELLNESS
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Dates
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Enumeration Date | 05/06/2019
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1861 BRIGHTSEAT RD
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City | LANDOVER
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State | MD
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Zip | 20785-4250
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Country | US
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Telephone | 301-276-5312
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Fax |
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Provider Business Mailing Address
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Address Line | 6111 43RD ST
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City | RIVERDALE
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State | MD
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Zip | 20737-1001
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Country | US
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Telephone | 910-797-9218
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. DARRELL COLEMAN JR.
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Credential | LCSW-C
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Telephone | 910-797-9218
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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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