| Nexus Wellness Group | |
|
10220 S Dolfield Rd Ste 204 Owings Mills MD 21117-3624 | |
| () - | |
| Not Available |
| Full Name | Nexus Wellness Group |
|---|---|
| Speciality | Social Worker |
| Location | 10220 S Dolfield Rd Ste 204, Owings Mills, Maryland |
| Authorized Official Name and Position | Ebony S Vaughan (OWNER) |
| Authorized Official Contact | 4103824536 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nexus Wellness Group 10220 S Dolfield Rd Ste 204 Owings Mills MD 21117-3624 Ph: (410) 382-4536 | Nexus Wellness Group 10220 S Dolfield Rd Ste 204 Owings Mills MD 21117-3624 Ph: () - |
| NPI Number | 1033877386 |
|---|---|
| Provider Enumeration Date | 12/03/2021 |
| Last Update Date | 12/03/2021 |
| Certification Date | 12/03/2021 |
| Medicare PECOS PAC ID | 3678951068 |
|---|---|
| Medicare Enrollment ID | O20220525001162 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033877386 | NPI | - | NPPES |
| 1871760397 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Ebony Samara Giddins Vaughan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871760397 PECOS PAC ID: 7911325311 Enrollment ID: I20200917000371 |
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