SHAPE SHIFTERS WELLNESS STUDIO, LLC (NPI# 1134516586) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134516586 |
| Entity Type | Organization |
| Organization Name | SHAPE SHIFTERS WELLNESS STUDIO, LLC |
| Practice Address |
169 Frederick Rd Ellicott City MD 21043-4886 |
| Mailing Address |
3614 Old Manse Ct Ellicott City MD 21043-4144 |
| Practice Telephone | 4433860818 |
| Practice Fax Number | 4104655522 |
| Mailing Telephone | 4433860818 |
| Mailing Fax Number | 4104655522 |
| Enumeration Date | 2015-04-23 |
| Last Update Date | 2015-04-23 |
| Authorized Official Name | ELLEN DRISCOLL (PHYSICAL THERAPIST/OWNER) |
| Authorized Official Telephone | 4433860818 |
| Authorized Official Credential | P.T. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 16510 | MD | Other Service Providers |
| Street Address |
169 FREDERICK RD |
| City | ELLICOTT CITY |
| State | MD |
| Zip Code | 21043-4886 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982242764 | Joyce Melinda Kelly | Social Worker | 8181 Main Street, 2nd Floor, Ellicott City, MD 21043 | 2019-12-12 |
| 1437703972 | Capitol Health Care, LLC | Speech-Language Pathologist | 4115 Sears House Court, Ellicott City, MD 21043 | 2019-08-01 |
| 1851857429 | Carol Ann Mckissick | Counselor | 2850 N. Ridge Rd. Suite 208a, Santoro Psychological Services, Ellicott City, MD 21043 | 2019-02-19 |
| 1659877017 | Tender Touch Healthcare Services LLC | In Home Supportive Care | 8960 Town and Country Blvd, Apt F, Ellicott, MD 21043 | 2018-04-04 |
| 1912426099 | Hf & Associates, LLC | Community/Behavioral Health | 3565 C2 Ellicott Mills Drive, Suite 202, Ellicott City, MD 21043 | 2017-09-11 |
| 1134666779 | Stephanie Jean | Behavioral Analyst | 8762 Town and Country Blvd, Ellicott City, MD 21043 | 2017-01-20 |
| 1124574744 | I Can't We Can Counseling Center | Preferred Provider Organization | 7060 O(akland Mills Rd, Columbia, MD 21043 | 2016-09-01 |
| 1598139925 | Jun Woo Lee | Chiropractor | 8492 Baltimore National Pike Suite 105, Ellicott City, MD 21043 | 2015-11-23 |
| 1518338953 | Byron Lam | Chiropractor | 2850 N Ridge Rd Ste 107a, Ellicott City, MD 21043 | 2015-10-12 |
| 1942682174 | Jea Sub Song | Chiropractor | 3460 Ellicott Center Dr Ste 102, Ellicott City, MD 21043 | 2015-06-24 |
| Find all providers in zip 21043 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598215147 | Grace Cody | Specialist | 8567 Harvest View Ct, Ellicott City, MD 21043-6560 | 2016-10-06 |
| 1982049714 | Laurie Alcock | Specialist | 5305 Sweet Birch Ct, Ellicott City, MD 21043-6304 | 2013-05-07 |
| 1215257159 | Jeannette Kay Nussbaum | Specialist | 8759 Stonehouse Drive, Ellicott City, MD 21043-1912 | 2010-06-02 |
| 1043427560 | John J Casey | Specialist | 9905 Whitworth Way, Ellicott City, MD 21042-5625 | 2007-05-16 |
| 1437374733 | Heather Amos | Specialist | 2201 Mount Hebron Ct, Ellicott City, MD 21042-1809 | 2007-04-13 |
| 1255463741 | Kara Mccourt-skeberdis | Specialist | 5016 Dorsey Hall Dr, Ste. 102, Ellicott City, MD 21042-7823 | 2007-03-10 |
| 1851457998 | Marcia Brandt Frezza | Specialist | 8978 Furrow Ave, Ellicott City, MD 21042-1857 | 2006-12-30 |
| 1891744595 | Arthur E Kurlanzik | Specialist | 3570 Saint Johns Ln, Ellicott City, MD 21042-4020 | 2006-05-09 |
| 1528039161 | Jeannine Erika George | Specialist | 3450 Ellicott Center Dr Ste 105, Ellicott City, MD 21043-4666 | 2006-01-31 |
| 1720068968 | Mohan Amlani | Specialist | 11336 Willow Ridge Ln, Ellicott City, MD 21042-2467 | 2006-01-21 |
| Find all providers in ELLICOTT CITY | ||||
| City | ELLICOTT CITY |
| Zip Code | 21043 |
Please comment or provide details below to improve the information on SHAPE SHIFTERS WELLNESS STUDIO, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.