Provider Demographics
NPI:1841806718
Name:DEVOTED WELLNESS AND COUNSELING SERVICES LLC
Entity Type:Organization
Organization Name:DEVOTED WELLNESS AND COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SERAPHINE
Authorized Official - Middle Name:
Authorized Official - Last Name:AGBOR
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:301-247-9039
Mailing Address - Street 1:28 W WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-6688
Mailing Address - Country:US
Mailing Address - Phone:301-247-9039
Mailing Address - Fax:
Practice Address - Street 1:28 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-6688
Practice Address - Country:US
Practice Address - Phone:301-247-9039
Practice Address - Fax:240-720-0342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-16
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty