RELEASE AND RENEW MENTAL WELLNESS CLINIC NPI 1972216869

NPI Information

  • NPI: 1972216869
  • Provider Name: RELEASE AND RENEW MENTAL WELLNESS CLINIC
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Organization
  • Former Legal Business Name: RELEASE AND RENEW MENTAL WELLNESS
  • Address: 1301 YORK RD STE 800
    LUTHERVILLE TIMONIUM, MD
    ZIP 21093
  • Phone: (410) 376-8728

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NPI Details

RELEASE AND RENEW MENTAL WELLNESS CLINIC is a psychiatric/mental health nurse practitioner in Lutherville Timonium, MD. RELEASE AND RENEW MENTAL WELLNESS CLINIC NPI is 1972216869. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Release And Renew Mental Wellness.

The provider's business location address is:

1301 YORK RD STE 800
LUTHERVILLE TIMONIUM, MD
ZIP 21093-011
Phone: (410) 376-8728
Fax: (410) 862-3774

The provider's authorized official is Tamara Pottillo .
The authorized official title is Owner and has the following contact phone number (443) 745-8620.

The enumeration date for this NPI number is 1/5/2023 and was last updated on 7/19/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YM0800XCounselorMental HealthNo
2251S00000XCommunity/Behavioral HealthNo
3363LP0808XNurse PractitionerPsychiatric/Mental HealthYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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