| Mentara Wellness LLC | |
|
3409 Henry Harford Dr Abingdon MD 21009-1130 | |
| (443) 865-4951 | |
| Not Available |
| Full Name | Mentara Wellness LLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 3409 Henry Harford Dr, Abingdon, Maryland |
| Authorized Official Name and Position | Tara Denise Henley (PSYCHIATRIC NURSE PRACTITIONER) |
| Authorized Official Contact | 4438654951 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mentara Wellness LLC 3409 Henry Harford Dr Abingdon MD 21009-1130 Ph: (443) 865-4951 | Mentara Wellness LLC 3409 Henry Harford Dr Abingdon MD 21009-1130 Ph: (443) 865-4951 |
| NPI Number | 1326921768 |
|---|---|
| Provider Enumeration Date | 07/30/2025 |
| Last Update Date | 07/30/2025 |
| Certification Date | 07/30/2025 |
| Medicare PECOS PAC ID | 7911498605 |
|---|---|
| Medicare Enrollment ID | O20251111000899 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326921768 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (NU) | Primary |
| Provider Name | Tara D Henley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912777368 PECOS PAC ID: 4082157789 Enrollment ID: I20240624000179 |
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