# RELEASE AND RENEW MENTAL WELLNESS CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Release and Renew Mental Wellness
- **Organization subpart:** No

## Provider details

- **NPI number:** 1972216869
- **Authorized official:** MRS. TAMARA POTTILLO APRN-PMH (OWNER)
- **Authorized official phone:** (443) 745-8620

## Contact information

- **Practice address:** 1301 YORK RD STE 800, LUTHERVILLE TIMONIUM, MD 21093-6011
- **Practice address phone:** (410) 376-8728
- **Practice address fax:** (410) 862-3774
- **Mailing address:** 1301 YORK RD STE 800, LUTHERVILLE TIMONIUM, MD 21093-6011
- **Mailing address phone:** (410) 376-8728
- **Mailing address fax:** (410) 862-3774

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 01/05/2023
- **Last updated:** 07/19/2024