MEDICARE: SELF INDULGENT LUXE: HEALTH & WELLNESS

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101YM0800X	Mental Health Counselor
2	103TH0100X	Health Service Psychologist
3	363LP2300X	Primary Care Nurse Practitioner

General Provider Information

NPI Number	:	1356270300
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SELF INDULGENT LUXE: HEALTH & WELLNESS

Provider Business Mailing Address
First Line	:	11002 ATWELL AVE
Second Line	:
City	:	BOWIE
State	:	MD
Zip	:	20720-3573
Country	:	US
Telephone Number	:	240-906-9462
Fax Number	:

Provider Business Practice Location Address
First Line	:	4410 74TH AVE
Second Line	:
City	:	HYATTSVILLE
State	:	MD
Zip	:	20784-2222
Country	:	US
Telephone Number	:	240-988-8502
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	JANAEL PALMER
Credential	:	NP
Telephone Number	:	240-906-9462

Provider Enumeration Date	:	05/15/2026
Last Update Date	:	05/15/2026

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Directions to “SELF INDULGENT LUXE: HEALTH & WELLNESS ” Practice Location

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