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General NPI Number Information
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NPI Number | 1922819713
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Entity Type | Organization
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Legal Business Name | BLUE FIELDS MENTAL HEALTH & WELLNESS, LC
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Dates
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Enumeration Date | 01/20/2025
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Last Update Date | 01/10/2026
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Provider Practice Location Address
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Address Line | 133 E MAIN ST
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City | FROSTBURG
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State | MD
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Zip | 21532-1336
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Country | US
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Telephone | 301-687-2555
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Fax | 463-300-5650
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Provider Business Mailing Address
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Address Line | 133 E MAIN ST
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City | FROSTBURG
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State | MD
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Zip | 21532-1336
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Country | US
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Telephone | 301-687-2555
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Fax | 463-300-5650
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Authorized Official
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Title or Position | OWNER/AUTHORIZED OFFICIAL
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Name | STEPHANIE JEANETTE BEDAL
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Credential | APRN, PMHNP
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Telephone | 301-687-2555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #4
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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 |
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