Organization
HOLISTIC WELLNESS & SUPPORT LLC.
Active
Organization
HOLISTIC WELLNESS & SUPPORT LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CARLTON GILBERT FONVILLE LCSW-C (EXECUTIVE DIRECTOR)
(301) 909-3887
Entity
Organization
Contact information
Practice address
8101 SANDY SPRING RD STE 300, LAUREL, MD 20707-3596
(301) 909-3887
Mailing address
8101 SANDY SPRING RD STE 300, LAUREL, MD 20707-3596
(301) 909-3887
(443) 279-2793
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
103K00000X
Behavior Analyst
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
1041S0200X
School Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
171400000X
Health & Wellness Coach
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
NONE
MD
Enumeration date
06/12/2021
Last updated
03/07/2022
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up