DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: WELLNESS SOURCE LLC

MEDICARE: WELLNESS SOURCE 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
12084P0802XAddiction Psychiatry Physician
22084P0800XPsychiatry Physician
3363LP0808XPsychiatric/Mental Health Nurse Practitioner
4364SP0809XAdult Psychiatric/Mental Health Clinical Nurse Specialist
5261QP2300XPrimary Care Clinic/Center
6363LF0000XFamily Nurse Practitioner

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3540582OTHERMDMEDICARE PTAN

Other Identifiers

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

General Provider Information

NPI Number : 1780031724
Entity Type Code : Organization
Provider Name (Legal Business Name) : WELLNESS SOURCE LLC
Provider Business Mailing Address
First Line : 4301 GARDEN CITY DR STE 304
Second Line :
City : HYATTSVILLE
State : MD
Zip : 20785-6105
Country : US
Telephone Number : 301-235-0600
Fax Number : 240-324-7720
Provider Business Practice Location Address
First Line : 4301 GARDEN CITY DR STE 304
Second Line :
City : HYATTSVILLE
State : MD
Zip : 20785-6105
Country : US
Telephone Number : 301-235-0060
Fax Number : 240-324-7720
Authorized Official
Title or Position : MEDICAL DIRECTOR
Name : MARSHALEE GEORGE
Credential :
Telephone Number : 301-235-0060
Provider Enumeration Date : 05/19/2016
Last Update Date : 05/27/2026

Similar Medicare Providers

1952370272 — DR. MARSHALEE GEORGE PHD, C.R.N.P., PMHNP
Practice Location Address:
4301 GARDEN CITY DR STE 304
HYATTSVILLE, MD
20785-6105
Practice Phone: 301-235-0060
Practice Fax:
1104872225 — KORDAI I DECOTEAU DPM
Practice Location Address:
4301 GARDEN CITY DR STE 304
HYATTSVILLE, MD
20785-6105
Practice Phone: 301-235-0060
Practice Fax: 240-324-7720
1114420320 — WELLNESS SOURCE LLC
Practice Location Address:
4301 GARDEN CITY DR STE 304
HYATTSVILLE, MD
20785-6105
Practice Phone: 301-235-0060
Practice Fax:
1205339413 — WELLNESS SOURCE LLC
Practice Location Address:
4301 GARDEN CITY DR STE 304
HYATTSVILLE, MD
20785-6105
Practice Phone: 301-235-0060
Practice Fax:
1235699620 — SARA FIORE SCHWARTZ CRNP
Practice Location Address:
4301 GARDEN CITY DR STE 304
HYATTSVILLE, MD
20785-6105
Practice Phone: 301-235-0060
Practice Fax: 240-324-7720
1588219059 — SUSAN MARIE LOPEZ RD
Practice Location Address:
4301 GARDEN CITY DR STE 304
HYATTSVILLE, MD
20785-6105
Practice Phone: 301-235-0600
Practice Fax:

Directions to “WELLNESS SOURCE LLC ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.