| Well Life Counseling And Consulting, Llc | |
|
9649 Belair Rd Ste 104 Nottingham MD 21236-1117 | |
| (410) 529-1309 | |
| (410) 529-1005 |
| Full Name | Well Life Counseling And Consulting, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 9649 Belair Rd Ste 104, Nottingham, Maryland |
| Authorized Official Name and Position | Julie Ann Beasman (PSYCHOLOGIST) |
| Authorized Official Contact | 4105291309 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Well Life Counseling And Consulting, Llc 9649 Belair Rd Ste 104 Nottingham MD 21236-1117 Ph: (410) 921-9078 | Well Life Counseling And Consulting, Llc 9649 Belair Rd Ste 104 Nottingham MD 21236-1117 Ph: (410) 529-1309 |
| NPI Number | 1891190054 |
|---|---|
| Provider Enumeration Date | 10/30/2014 |
| Last Update Date | 06/17/2023 |
| Certification Date | 06/17/2023 |
| Medicare PECOS PAC ID | 0446573166 |
|---|---|
| Medicare Enrollment ID | O20150102000734 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891190054 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 04581 (Maryland) | Primary |
| Provider Name | Julie A Beasman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1558593988 PECOS PAC ID: 7315093085 Enrollment ID: I20090922000221 |
| Provider Name | Jaimie Ryan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568723609 PECOS PAC ID: 2860796752 Enrollment ID: I20160215000152 |
| Provider Name | Christine Lynne Martin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1396865168 PECOS PAC ID: 1153510912 Enrollment ID: I20171023001006 |
| Provider Name | Emalee Joyce Weidemann Quickel |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1437381118 PECOS PAC ID: 5890117220 Enrollment ID: I20200612000286 |
| Provider Name | Antonio W Herold |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588286520 PECOS PAC ID: 8426464249 Enrollment ID: I20210302003224 |
| Provider Name | Laura Csw Massaro |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578889374 PECOS PAC ID: 4486039054 Enrollment ID: I20220917000624 |
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