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General NPI Number Information
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NPI Number | 1790329894
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Entity Type | Organization
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Legal Business Name | COMPLETE WELLNESS RECOVERY, INC
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Dates
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Enumeration Date | 10/31/2019
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Last Update Date | 06/30/2021
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Provider Practice Location Address
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Address Line | 11 1/2 W CHASE ST
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City | BALTIMORE
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State | MD
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Zip | 21201-5473
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Country | US
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Telephone | 443-961-3050
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Fax | 443-957-9485
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Provider Business Mailing Address
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Address Line | 10 W MADISON ST STE 11
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City | BALTIMORE
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State | MD
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Zip | 21201-2313
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Country | US
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Telephone | 443-438-7863
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Fax | 443-957-9485
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Authorized Official
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Title or Position | LICENSED PSYCHOLOGIST
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Name | DR. WILLIAM DURWOOD WHITTEN
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Credential | PHD
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Telephone | 443-438-7863
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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 |
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Taxonomy #2
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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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 | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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