Organization
BEWELL THERAPY GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMILY PAVLICK LCSW-C (OWNER/OPERATOR/FOUNDER)
(301) 793-9915
Entity
Organization
Contact information
Practice address
18008 BLISS DR, POOLESVILLE, MD 20837-2401
(301) 793-9915
Mailing address
18008 BLISS DR, POOLESVILLE, MD 20837-2401
(301) 793-9915
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
07/06/2021
Last updated
07/06/2021
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