Healthcare Provider Details

I. General information

NPI: 1558265595
Provider Name (Legal Business Name): HALCYON MENTAL HEALTH DMV LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 W REDWOOD ST # 8081
BALTIMORE MD
21201-1708
US

IV. Provider business mailing address

306 W REDWOOD ST # 8081
BALTIMORE MD
21201-1708
US

V. Phone/Fax

Practice location:
  • Phone: 704-294-0066
  • Fax: 844-644-5238
Mailing address:
  • Phone: 704-294-0066
  • Fax: 844-644-5238

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name: AIMEE WHALEY
Title or Position: OWNER
Credential:
Phone: 704-294-0066