Provider Demographics
NPI:1477914042
Name:WAYPOINT INTEGRATIVE HEALTH LLC
Entity Type:Organization
Organization Name:WAYPOINT INTEGRATIVE HEALTH LLC
Other - Org Name:WELLNESS WITHIN HOLISTIC HEALING
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:DOM, MS, MAC, LAC
Authorized Official - Phone:410-914-7198
Mailing Address - Street 1:631 CRESSWELL RD
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MD
Mailing Address - Zip Code:21225-3812
Mailing Address - Country:US
Mailing Address - Phone:410-914-7198
Mailing Address - Fax:443-842-6168
Practice Address - Street 1:1439 E FORT AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21230-5575
Practice Address - Country:US
Practice Address - Phone:410-914-7198
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-10
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU02196171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDCE-890001OtherCAREFIRST BLUE CROSS BLUE SHIELD