MEDICARE: CONNECTED SELF, 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
1	106H00000X	Marriage & Family Therapist	LCM130	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	361133	OTHER	MD	MHN
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932270568
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CONNECTED SELF, LLC

Provider Business Mailing Address
First Line	:	3012 MITCHELLVILLE RD
Second Line	:	SUITE 103
City	:	BOWIE
State	:	MD
Zip	:	20716-3986
Country	:	US
Telephone Number	:	301-218-0836
Fax Number	:	301-218-0836

Provider Business Practice Location Address
First Line	:	3012 MITCHELLVILLE RD
Second Line	:	SUITE 103
City	:	BOWIE
State	:	MD
Zip	:	20716-3986
Country	:	US
Telephone Number	:	301-218-0836
Fax Number	:	301-218-0836

Authorized Official
Title or Position	:	OWNER, SOLE THERAPIST
Name	:	MS. MERLINA ALYCE PERKOWSKI
Credential	:	LCMFT
Telephone Number	:	301-218-0836

Provider Enumeration Date	:	11/13/2006
Last Update Date	:	03/10/2014

Similar Medicare Providers

1225109861 — MS. MERLINA ALYCE PERKOWSKI LCMFT
Practice Location Address:

3012 MITCHELLVILLE RD , SUITE 103
BOWIE, MD
20716-3986

Practice Phone: 301-218-0836
Practice Fax: 301-218-0836

1922986439 — NUMENTE HEALTH LLC
Practice Location Address:

16575 FIFE WAY
BOWIE, MD
20716-1894

Practice Phone: 240-215-7631
Practice Fax:

1255078572 — ROBIN CODJOE MD
Practice Location Address:

14999 HEALTH CENTER DR STE 201
BOWIE, MD
20716-1087

Practice Phone: 301-262-6797
Practice Fax: 866-701-4905

1629931316 — JARVIS TAKAPA
Practice Location Address:

15924 ALAMEDA DR
BOWIE, MD
20716-1331

Practice Phone: 202-894-0159
Practice Fax:

1811573843 — IJEOMA G AHAGHOTU FNP
Practice Location Address:

4305 NORTHVIEW DR STE 38
BOWIE, MD
20716-2600

Practice Phone: 301-235-9999
Practice Fax: 301-235-9950

1386478782 — ACCESS HEALTHCARE AND WELLNESS LLC
Practice Location Address:

4305 NORTHVIEW DR STE 38
BOWIE, MD
20716-2600

Practice Phone: 301-235-9999
Practice Fax: 301-235-9950

Directions to “CONNECTED SELF, 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 © 2007-2025 (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.