Healthcare Provider Details

I. General information

NPI: 1114848660
Provider Name (Legal Business Name): HEAD STRONG THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10440 LITTLE PATUXENT PKWY STE 300
COLUMBIA MD
21044-3648
US

IV. Provider business mailing address

10440 LITTLE PATUXENT PKWY STE 300
COLUMBIA MD
21044-3648
US

V. Phone/Fax

Practice location:
  • Phone: 240-483-8368
  • Fax: 207-464-9111
Mailing address:
  • Phone: 240-929-8277
  • Fax: 207-464-9111

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: MRS. PHANEDRA AINE O'NEAL
Title or Position: OWNER
Credential: PSYCH NP
Phone: 240-483-8368