REVERED-HOLISTIC HEALTHCARE LLC
NPI 1205525334
Clinic/Center - Mental Health (Including Community Mental Health Center) in Columbia, MD

Q: What is Revered-Holistic Healthcare LLC's NPI number?

The NPI number for Revered-Holistic Healthcare LLC is 1205525334. It was assigned to this organization in the NPPES registry on May 4, 2023.

Q: What is Revered-Holistic Healthcare 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.

Active since May 04, 2023

9861 BROKEN LAND PKWY STE 100, COLUMBIA, MD 21046(410) 399-4240(443) 381-0216 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Sep 11, 2025, May 4, 2023 (2 updates tracked since 2023).

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About Revered-holistic Healthcare Llc NPPES

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

REVERED-HOLISTIC HEALTHCARE LLC (NPI 1205525334) is a healthcare organization registered as a mental health (including community mental health center) in Columbia, Maryland and active in the NPI registry since May 2023. The organization lists Adetutu Awodipe, President, as its authorized official.

NPPES Registry Identity

NPI1205525334

Entity TypeOrganization

Primary Taxonomy261QM0801X

Legal Business NameREVERED-HOLISTIC HEALTHCARE LLC

Location Address9861 BROKEN LAND PKWY STE 100Columbia, MD 21046-3031

Mailing Address4518 Runnymeade RdOwings Mills, MD 21117-6156 · (410) 399-4240 · Fax (443) 381-0216

Phone(410) 399-4240

Fax(443) 381-0216

Organization SubpartNo

Authorized OfficialAdetutu AwodipePresident · (443) 621-2203

Enumeration DateMay 4, 2023

Last NPPES UpdateSeptember 11, 20252 updates tracked since enumeration

NPPES CertifiedSeptember 11, 2025

✔ NPI 1205525334 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Mental Health (Including Community Mental Health Center)Ambulatory Health Care Facilities

Taxonomy Code261QM0801X

Also ListedNurse Practitioner · Psychiatric/Mental HealthTaxonomy 363LP0808X

9861 BROKEN LAND PKWY STE 100, Columbia, MD 21046

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-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)

Revered-holistic Healthcare Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Revered-Holistic Healthcare LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Adetutu Awodipe, NP

Nurse Practitioner

NPI 1386157857

9861 BROKEN LAND PKWY STE 100
Columbia, MD 21046

(410) 399-4240

✔ PECOS✔ Accepts MedicareSame address

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 Revered-Holistic Healthcare LLC's NPI number?

The NPI number for Revered-Holistic Healthcare LLC is 1205525334. It was assigned to this organization in the NPPES registry on May 4, 2023.

Where is Revered-Holistic Healthcare LLC located?

Revered-Holistic Healthcare LLC is located at 9861 Broken Land Pkwy Ste 100, Columbia, MD 21046. The listed phone number is (410) 399-4240.

What is Revered-Holistic Healthcare 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 Revered-Holistic Healthcare LLC enrolled in Medicare?

Yes. Revered-Holistic Healthcare LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Revered-Holistic Healthcare LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Revered-Holistic Healthcare 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Revered-Holistic Healthcare LLC was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.