Holistic Wellness & Support Llc.

NPI #1427626837 in Laurel, Maryland

Provider Information

NPI Number: 1427626837
Entity Type: Organization
Organization Name: Holistic Wellness & Support Llc.
Primary Specialty: Social Worker - Clinical
Enumeration Date: Jun 12, 2021
Last Updated: Mar 7, 2022

Practice Location

Address: 8101 SANDY SPRING RD STE 300
City: Laurel
State: Maryland
ZIP Code: 20707-3596
Phone: (301) 909-3887

Authorized Official

Name: MR. CARLTON GILBERT FONVILLE, LCSW-C
Title: EXECUTIVE DIRECTOR
Phone: (301) 909-3887

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder)	101YA0400X
Counselor - Mental Health — Mental Health	101YM0800X
Counselor - Professional — Professional	101YP2500X
Behavior Analyst	103K00000X
Social Worker - School — School	1041S0200X
Marriage & Family Therapist	106H00000X
Health & Wellness Coach	171400000X
Case Manager/Care Coordinator	171M00000X
Social Worker - Clinical — Clinical	1041C0700X	Primary

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