MEDICARE: CAREVINA BEHAVIORAL HEALTH LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1144183047
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAREVINA BEHAVIORAL HEALTH LLC

Provider Business Mailing Address
First Line	:	46940 S SHANGRI LA DR STE 100-13
Second Line	:
City	:	LEXINGTON PARK
State	:	MD
Zip	:	20653-1037
Country	:	US
Telephone Number	:	240-510-4216
Fax Number	:

Provider Business Practice Location Address
First Line	:	46940 S SHANGRI LA DR STE 100-13
Second Line	:
City	:	LEXINGTON PARK
State	:	MD
Zip	:	20653-1037
Country	:	US
Telephone Number	:	240-510-4216
Fax Number	:

Authorized Official
Title or Position	:	MD
Name	:	ADEBOLA AYANDA-WILSON
Credential	:
Telephone Number	:	240-510-4216

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/08/2025

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