=====================================================
General NPI Number Information
=====================================================
NPI Number | 1861356941
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SPERANZA WELLNESS SOLUTIONS, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/12/2025
-----------------------------------------------------
Last Update Date | 12/12/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 517 BENFIELD RD
-----------------------------------------------------
City | SEVERNA PARK
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21146-2527
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-385-3040
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 11296 LAURELWALK DR
-----------------------------------------------------
City | LAUREL
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20708-3005
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-385-3040
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PSYCHIATRIC NURSE PRACTITIONER
-----------------------------------------------------
Name | DR. MAUREEN MUBOH NDZI
-----------------------------------------------------
Credential | DNP, PMHNP-BC, CCM
-----------------------------------------------------
Telephone | 301-385-3040
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------