Healthcare Provider Details

I. General information

NPI: 1649174954
Provider Name (Legal Business Name): TRANQUIL MINDS MENTAL HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6340 SECURITY BLVD STE 100
BALTIMORE MD
21207-5284
US

IV. Provider business mailing address

6340 SECURITY BLVD STE 100
BALTIMORE MD
21207-5284
US

V. Phone/Fax

Practice location:
  • Phone: 667-293-9474
  • Fax:
Mailing address:
  • Phone: 667-293-9474
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: PATTIE RAY
Title or Position: OWNER
Credential: PMHNP-BC
Phone: 667-293-9474