MEDICARE: MOUNTAIN VIEW THERAPEUTIC WELLNESS CENTER

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1952089724
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOUNTAIN VIEW THERAPEUTIC WELLNESS CENTER

Provider Business Mailing Address
First Line	:	3703 N ROLLING RD APT D
Second Line	:
City	:	WINDSOR MILL
State	:	MD
Zip	:	21244-3346
Country	:	US
Telephone Number	:	410-705-0949
Fax Number	:

Provider Business Practice Location Address
First Line	:	3703 N ROLLING RD APT D
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21244-3346
Country	:	US
Telephone Number	:	410-705-0949
Fax Number	:

Authorized Official
Title or Position	:	OWNER/THERAPIST
Name	:	KISHMA M TROTMAN
Credential	:	LCSW-C
Telephone Number	:	410-705-0949

Provider Enumeration Date	:	07/10/2023
Last Update Date	:	12/16/2025

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