Healthcare Provider Details

I. General information

NPI: 1720569882
Provider Name (Legal Business Name): MIGHTY BEHAVIORAL HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2018
Last Update Date: 07/30/2025
Certification Date: 07/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 E LEXINGTON ST STE 100
BALTIMORE MD
21202-1732
US

IV. Provider business mailing address

11 E LEXINGTON ST STE 100
BALTIMORE MD
21202-1732
US

V. Phone/Fax

Practice location:
  • Phone: 667-260-2933
  • Fax: 410-826-3855
Mailing address:
  • Phone: 667-260-2933
  • Fax: 410-826-3855

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License Number
License Number State

VIII. Authorized Official

Name: BENNY A MESFIN
Title or Position: PSYCHIATRIC NURSE PRACTITONER
Credential: CRNP-PMH
Phone: 512-947-2747