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NPI Code Detail

MEDICARE: MS. PRECIOUS WELLS LCPC

MEDICARE: MS. PRECIOUS WELLS LCPC
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
1101YM0800XMental Health CounselorLC13365MD
2101YP2500XProfessional CounselorLC13365MD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1LC13365OTHERMDMARYLAND LICENSE
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1679232953
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. PRECIOUS WELLS LCPC
Provider Business Mailing Address
First Line : 10490 LITTLE PATUXENT PKWY STE 600
Second Line :
City : COLUMBIA
State : MD
Zip : 21044-4941
Country : US
Telephone Number : 443-583-8935
Fax Number :
Provider Business Practice Location Address
First Line : 10490 LITTLE PATUXENT PKWY STE 600
Second Line :
City : COLUMBIA
State : MD
Zip : 21044-4941
Country : US
Telephone Number : 443-583-8935
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/14/2021
Last Update Date : 10/22/2025

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