MEDICARE: BIRDIES NEST THERAPEUTIC & CONSULTING SERVICES LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251B00000X	Case Management Agency
2	251S00000X	Community/Behavioral Health Agency
3	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1699289843
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BIRDIES NEST THERAPEUTIC & CONSULTING SERVICES LLC

Provider Business Mailing Address
First Line	:	2612 TALBOT CT
Second Line	:
City	:	WALDORF
State	:	MD
Zip	:	20602-2017
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4095 SILVER PARK TER
Second Line	:
City	:	SUITLAND
State	:	MD
Zip	:	20746-3047
Country	:	US
Telephone Number	:	240-523-3381
Fax Number	:

Authorized Official
Title or Position	:	CEO AND FOUNDER/ LEAD CLINICIAN
Name	:	DR. SABRIE RENEE WIGGINS-ROSE
Credential	:	LCPC-S
Telephone Number	:	240-523-3381

Provider Enumeration Date	:	11/27/2017
Last Update Date	:	01/07/2026

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