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Organization
MARYLAND WELLNESS LLC
Active
Organization
MARYLAND WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SIERRA BURLEY (CREDENTIALING SPECISLIST)
(410) 314-1030
Entity
Organization
Contact information
Practice address
4200 FORBES BLVD STE 104, LANHAM, MD 20706-4872
(410) 314-1030
(410) 314-1030
Mailing address
4128 HAYWARD AVE, BALTIMORE, MD 21215-4340
(410) 314-1030
(410) 314-1030
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200710000
MD DEPARTMENT OF HEALTH - OUTPATIENT MENTAL HEALTH CENTER (OMHC) - ADULT
MD
Enumeration date
01/27/2023
Last updated
04/16/2025
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