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ADDICTION WELLNESS CENTER LLC
NPI 1912760877
Nurse Practitioner - Adult Health in Quantico, MD

Active since February 02, 2024
5438 SANDY HILL RD STE A, QUANTICO, MD 21856(443) 547-2964 Get Directions Write a Review

NPPES record last updated: February 28, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 28, 2025, Aug 1, 2024 (2 updates tracked since 2024).

About Addiction Wellness Center Llc NPPES

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

ADDICTION WELLNESS CENTER LLC (NPI 1912760877) is a healthcare organization registered as an adult health in Quantico, Maryland and active in the NPI registry since February 2024. The organization lists Jessie Costley, Credentialing Specialist, as its authorized official.

NPPES Registry Identity

NPI1912760877
Entity TypeOrganization
Primary Taxonomy363LA2200X
Legal Business NameADDICTION WELLNESS CENTER LLC
Location Address5438 SANDY HILL RD STE AQuantico, MD 21856-2100
Mailing Address5438 Sandy Hill Rd Ste AQuantico, MD 21856-2100 · (443) 547-2964
Phone(443) 547-2964
Organization SubpartYes
Authorized OfficialJessie CostleyCredentialing Specialist · (443) 839-6928
Enumeration DateFebruary 2, 2024
Last NPPES UpdateFebruary 28, 20252 updates tracked since enumeration
NPPES CertifiedFebruary 28, 2025
✔ NPI 1912760877 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2200X
5438 SANDY HILL RD STE A, Quantico, MD 21856
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Other Identifiers 1

Medicaid213477200MD

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

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

ADDICTION WELLNESS CENTER LLC
Clinic/Center (Mental Health (Including Community Mental Health Center))
5438 SANDY HILL RD STE A
QUANTICO, MD 21856
Wicomico County (443) 547-2964

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 Addiction Wellness Center LLC's NPI number?

The NPI number for Addiction Wellness Center LLC is 1912760877. It was assigned to this organization in the NPPES registry on February 2, 2024.

Where is Addiction Wellness Center LLC located?

Addiction Wellness Center LLC is located at 5438 Sandy Hill Rd Ste A, Quantico, MD 21856. The listed phone number is (443) 547-2964.

What is Addiction Wellness Center LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

When was this NPI record last updated?

The NPPES record for Addiction Wellness Center LLC was last updated on February 28, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.