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NPI Code Detail

MEDICARE: A RAE OF HOPE WELLNESS, LLC

MEDICARE: A RAE OF HOPE WELLNESS, 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
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1396696910
Entity Type Code : Organization
Provider Name (Legal Business Name) : A RAE OF HOPE WELLNESS, LLC
Provider Business Mailing Address
First Line : 12410 MILESTONE CENTER DR STE 600
Second Line :
City : GERMANTOWN
State : MD
Zip : 20876-7102
Country : US
Telephone Number : 571-457-9306
Fax Number :
Provider Business Practice Location Address
First Line : 12410 MILESTONE CENTER DR STE 600
Second Line :
City : GERMANTOWN
State : MD
Zip : 20876-7102
Country : US
Telephone Number : 240-723-0707
Fax Number :
Authorized Official
Title or Position : OWNER
Name : TAHJA-RAE DICKENSON
Credential : LCSW
Telephone Number : 571-457-9306
Provider Enumeration Date : 02/09/2026
Last Update Date : 02/09/2026

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Directions to “A RAE OF HOPE WELLNESS, LLC ” Practice Location

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