Organization
HOLISTIC WELLNESS SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICKIE COOKE LCADC (CEO / FOUNDER)
(443) 629-0646
Entity
Organization
Contact information
Practice address
3806 RAVENWOOD AVE, BALTIMORE, MD 21213-2022
(443) 629-0646
Mailing address
PO BOX 3394, BALTIMORE, MD 21213-0394
(443) 629-0646
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
12/06/2022
Last updated
12/06/2022
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