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SELF
NPI 1770255291
Nurse Practitioner - Psychiatric/Mental Health in Glen Burnie, MD

Active since October 03, 2021
1406B CRAIN HWY S STE 304, GLEN BURNIE, MD 21061(301) 804-0344 Get Directions Write a Review

NPPES record last updated: December 19, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Dec 19, 2022, Oct 3, 2021 (2 updates tracked since 2021).

About Self NPPES

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

SELF (NPI 1770255291) is a healthcare organization registered as a psychiatric/mental health in Glen Burnie, Maryland and active in the NPI registry since October 2021. The organization lists Donna Boatman, Credentialing Manager, as its authorized official.

NPPES Registry Identity

NPI1770255291
Entity TypeOrganization
Primary Taxonomy363LP0808X
Legal Business NameHEALTH RELEAF LLC
Location Address1406B CRAIN HWY S STE 304Glen Burnie, MD 21061-4094
Mailing Address1406b Crain Hwy S Ste 304Glen Burnie, MD 21061-4094 · (301) 804-0344
Phone(301) 804-0344
Organization SubpartNo
Authorized OfficialDonna BoatmanCredentialing Manager · (301) 399-6874
Enumeration DateOctober 3, 2021
Last NPPES UpdateDecember 19, 20222 updates tracked since enumeration
NPPES CertifiedDecember 19, 2022
✔ NPI 1770255291 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
1406B CRAIN HWY S STE 304, Glen Burnie, MD 21061
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Other Names 1

Doing Business AsSelf

Other Identifiers 1

Medicaid633004500MD

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

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NEW CHANGES LLC
Nurse Practitioner (Psychiatric/Mental Health)
1406B CRAIN HWY S STE 304
GLEN BURNIE, MD 21061
Anne Arundel County (301) 804-0344
HEALTH RELEAF LLC
Clinic/Center (Primary Care)
1406B CRAIN HWY S STE 304
GLEN BURNIE, MD 21061
Anne Arundel County (301) 804-0322
MRS. SHANNON NICOLE MARTIN FNP-C
Nurse Practitioner (Family)
1406B CRAIN HWY S STE 304
GLEN BURNIE, MD 21061
Anne Arundel County (301) 804-0344
NEW CHANGES LLC
Nurse Practitioner (Family)
1406B CRAIN HWY S STE 304
GLEN BURNIE, MD 21061
Anne Arundel County (301) 804-0344

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 Health Releaf LLC's NPI number?

The NPI number for Health Releaf LLC is 1770255291. It was assigned to this organization in the NPPES registry on October 3, 2021. The provider is doing business as Self.

Where is Health Releaf LLC located?

Health Releaf LLC is located at 1406B Crain Hwy S Ste 304, Glen Burnie, MD 21061. The listed phone number is (301) 804-0344.

What is Health Releaf LLC's specialty?

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

When was this NPI record last updated?

The NPPES record for Health Releaf LLC was last updated on December 19, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.