# NLW YOUTH DEVELOPMENT PROGRAM

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

## Provider details

- **NPI number:** 1639037070
- **Authorized official:** NICKEL LATANYA WALSTON (OWNER)
- **Authorized official phone:** (443) 303-6615

## Contact information

- **Practice address:** 2504 SAINT PAUL ST STE 1, BALTIMORE, MD 21218-4606
- **Practice address phone:** (443) 360-8936
- **Mailing address:** 2504 SAINT PAUL ST STE 1, BALTIMORE, MD 21218-4606
- **Mailing address phone:** (443) 360-8936

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |

## Other

- **Enumeration date:** 01/14/2026
- **Last updated:** 01/14/2026