# CERVELLO-WELLNESS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083239255
- **Authorized official:** MIMI TYSON (PSYCHIATRIC NURSE PRACTITIONER)
- **Authorized official phone:** (301) 392-7120

## Contact information

- **Practice address:** 6010 EXECUTIVE BLVD STE 700, NORTH BETHESDA, MD 20852-3885
- **Practice address phone:** (301) 392-7120
- **Mailing address:** 4014 DIAMONDHEAD AVE, BOWIE, MD 20721-1308
- **Mailing address phone:** (301) 828-5239

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 06/12/2020
- **Last updated:** 05/30/2026