Provider Demographics
NPI:1083449771
Name:BIRTHSTONE WELLNESS
Entity type:Organization
Organization Name:BIRTHSTONE WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:TASHA
Authorized Official - Middle Name:N
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:410-305-9093
Mailing Address - Street 1:1 E CHASE ST STE 1128
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21202-2565
Mailing Address - Country:US
Mailing Address - Phone:410-305-9093
Mailing Address - Fax:443-378-7409
Practice Address - Street 1:1 E CHASE ST STE 1128
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-2565
Practice Address - Country:US
Practice Address - Phone:410-305-9093
Practice Address - Fax:443-378-7409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-03
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)