Healthcare Provider Details

I. General information

NPI: 1659254621
Provider Name (Legal Business Name): JUST MIND PSYCHIATRY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

712 H ST NE STE 1379
WASHINGTON DC
20002-3627
US

IV. Provider business mailing address

712 H ST NE STE 1379
WASHINGTON DC
20002-3627
US

V. Phone/Fax

Practice location:
  • Phone: 571-275-5935
  • Fax:
Mailing address:
  • Phone: 571-275-5935
  • Fax: 877-565-1607

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: IVY DZIFA DZIVENU
Title or Position: OWNER
Credential:
Phone: 571-275-5935