Organization
EDEN PLACE HEALING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LOVELY MOULTON LCPC, LCADC (EXECUTIVE DIRECTOR)
(443) 674-6343
Entity
Organization
Contact information
Practice address
3911 FAIRVIEW AVE, BALTIMORE, MD 21216-1229
(443) 674-6343
Mailing address
PO BOX 2602, BALTIMORE, MD 21215-0003
(443) 674-6343
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
08/20/2025
Last updated
04/02/2026
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