Provider Demographics
NPI:1154101921
Name:GLADWELL LLC
Entity type:Organization
Organization Name:GLADWELL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:WANJIRU
Authorized Official - Last Name:DONNERSTAG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-600-8467
Mailing Address - Street 1:1015 DEBBIE AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21221-3339
Mailing Address - Country:US
Mailing Address - Phone:253-508-8538
Mailing Address - Fax:
Practice Address - Street 1:1015 DEBBIE AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21221-3339
Practice Address - Country:US
Practice Address - Phone:253-509-4433
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-29
Last Update Date:2025-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty