Healthcare Provider Details

I. General information

NPI: 1003773631
Provider Name (Legal Business Name): BRIGHTERMINDANDMENTALWELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2026
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8222 SCHULTZ RD STE 102
CLINTON MD
20735-2607
US

IV. Provider business mailing address

8222 SCHULTZ RD STE 102
CLINTON MD
20735-2607
US

V. Phone/Fax

Practice location:
  • Phone: 240-899-1534
  • Fax:
Mailing address:
  • Phone: 240-899-1534
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: ADEMOLA BISIRIYU
Title or Position: OWNER
Credential: PMHNP
Phone: 202-704-8741