MARYLAND WELLNESS LLC
NPI 1003479668
Clinic/Center - Mental Health (Including Community Mental Health Center) in Baltimore, MD
About Maryland Wellness Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MARYLAND WELLNESS LLC (NPI 1003479668) is a healthcare organization registered as a mental health (including community mental health center) in Baltimore, Maryland and active in the NPI registry since April 2019. The organization holds a CLIA Waiver certificate valid through August 3, 2028, maintains 7 additional practice locations, and lists Sierra Burley, Credentialing Specialist, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 4
Secondary Practice Locations 7
Other Identifiers 6
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Maryland Wellness Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
28Medicare enrollment records show 28 clinicians reassign Medicare billing to Maryland Wellness LLC, which bills Medicare for the services they deliver. Of these, 4 practice at this address and 7 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 4
Nearest to this location (20)
See all 28Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 21D2348287
Maryland Wellness LLC · Baltimore, MDFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Maryland Wellness LLC's NPI number?
The NPI number for Maryland Wellness LLC is 1003479668. It was assigned to this organization in the NPPES registry on April 19, 2019.
Where is Maryland Wellness LLC located?
Maryland Wellness LLC is located at 4128 Hayward Ave # W, Baltimore, MD 21215. The listed phone number is (410) 994-6491.
What is Maryland Wellness LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.
Is Maryland Wellness LLC enrolled in Medicare?
Yes. Maryland Wellness LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Maryland Wellness LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 28 clinicians in 4 Medicare specialties reassign their Medicare billing to Maryland Wellness LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Clinical Social Worker (11), Mental Health Counselor (11) and Nurse Practitioner (5). Of these, 4 practice at this address and 7 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Maryland Wellness LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 21D2348287) is associated with this NPI, valid through August 3, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Maryland Wellness LLC was last updated on April 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Maryland Wellness Llc · NPI 1003479668
Mental Health (Including Community Mental Health Center) organization in Baltimore, Maryland. Organization record, active in the CMS NPPES registry since April 19, 2019.
## Identity
- **NPI:** 1003479668 (Entity type: Organization)
- **Enumerated:** April 19, 2019
- **Primary specialty:** Clinic/Center - Mental Health (Including Community Mental Health Center) · taxonomy 261QM0801X
- **Organization subpart:** No
- **Authorized official:** Sierra Burley, CREDENTIALING SPECIALIST
## Practice location
- **Address:** 4128 HAYWARD AVE # W, Baltimore, MD 21215-4340
- **Phone:** (410) 994-6491
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 28 clinicians in 4 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Clinical Social Worker (11), Mental Health Counselor (11), Nurse Practitioner (5); 4 practice at this address and 7 within 10 miles; [full list](https://npiprofile.com/npi/1003479668/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 16, 2025
- **Other identifiers:** Medicaid 907713800 (MD); Other 220412461 (MD); Other 220412462 (MD); and 3 more
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1003479668) · Data from the CMS NPPES public registry.