Provider Demographics
NPI:1437548237
Name:WAYPOINT WELLNESS CENTER, LLC
Entity Type:Organization
Organization Name:WAYPOINT WELLNESS CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALLYSON
Authorized Official - Middle Name:K
Authorized Official - Last Name:WAGNAER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-684-3806
Mailing Address - Street 1:877 BALTIMORE ANNAPOLIS BLVD STE 203
Mailing Address - Street 2:
Mailing Address - City:SEVERNA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:21146-4716
Mailing Address - Country:US
Mailing Address - Phone:410-684-3806
Mailing Address - Fax:
Practice Address - Street 1:166 DEFENSE HWY STE 203
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-8922
Practice Address - Country:US
Practice Address - Phone:410-684-3806
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-16
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04890103T00000X
MD04712103T00000X
103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty