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CERVELLO-WELLNESS, LLC
NPI 1083239255
Nurse Practitioner - Psychiatric/Mental Health in North Bethesda, MD

Active since June 12, 2020
6010 EXECUTIVE BLVD STE 700, NORTH BETHESDA, MD 20852(301) 392-7120 Get Directions Write a Review

NPPES record last updated: May 30, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 30, 2026, Feb 3, 2025, Dec 13, 2020 and 1 more (4 updates tracked since 2020).

About Cervello-wellness, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CERVELLO-WELLNESS, LLC (NPI 1083239255) is a healthcare organization registered as a psychiatric/mental health in North Bethesda, Maryland and active in the NPI registry since June 2020. The organization maintains a secondary practice location in Alexandria and lists Mimi Tyson, Psychiatric Nurse Practitioner, as its authorized official.

NPPES Registry Identity

NPI1083239255
Entity TypeOrganization
Primary Taxonomy363LP0808X
Legal Business NameCERVELLO-WELLNESS, LLC
Location Address6010 EXECUTIVE BLVD STE 700North Bethesda, MD 20852-3885
Mailing Address4014 Diamondhead AveBowie, MD 20721-1308 · (301) 828-5239
Phone(301) 392-7120
Organization SubpartNo
Authorized OfficialMimi TysonPsychiatric Nurse Practitioner · (301) 392-7120
Enumeration DateJune 12, 2020
Last NPPES UpdateMay 30, 20264 updates tracked since enumeration
NPPES CertifiedMay 30, 2026
✔ NPI 1083239255 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
6010 EXECUTIVE BLVD STE 700, North Bethesda, MD 20852
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Secondary Practice Location 1

Location 1403 N Henry StAlexandria, VA 22314-2230 · Phone (301) 392-7120

Other Identifiers 1

Medicaid521090900MD

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Cervello-wellness, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Cervello-Wellness, LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.

Clinicians, nearest first (3)

Mimi Tyson
Nurse Practitioner
NPI 1952960924
6010 EXECUTIVE BLVD STE 700
North Bethesda, MD 20852
(301) 392-7120
✔ PECOS✔ Accepts MedicareSame address
Lee Anna Belton, LICSW
Clinical Social Worker
NPI 1609069426
5169 CLACTON AVE
Suitland, MD 20746
(978) 821-5114
✔ PECOS✔ Accepts Medicare20 mi
Ashley Buckner, LCSW
Clinical Social Worker
NPI 1215241930
725 WELCH RD
Palo Alto, CA 94304
(650) 497-8000
✔ PECOS✔ Accepts Medicare2,428 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently 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 Cervello-Wellness, LLC's NPI number?

The NPI number for Cervello-Wellness, LLC is 1083239255. It was assigned to this organization in the NPPES registry on June 12, 2020.

Where is Cervello-Wellness, LLC located?

Cervello-Wellness, LLC is located at 6010 Executive Blvd Ste 700, North Bethesda, MD 20852. The listed phone number is (301) 392-7120.

What is Cervello-Wellness, LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Cervello-Wellness, LLC enrolled in Medicare?

Yes. Cervello-Wellness, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Cervello-Wellness, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Cervello-Wellness, LLC, in Clinical Social Worker and Nurse Practitioner. 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. Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Cervello-Wellness, LLC was last updated on May 30, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.