Healthcare Provider Details

I. General information

NPI: 1518639202
Provider Name (Legal Business Name): HEALTHY MINDSETS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2021
Last Update Date: 05/01/2022
Certification Date: 05/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8737 BROOKS DR STE 102
EASTON MD
21601-7474
US

IV. Provider business mailing address

8707 COMMERCE DR STE D
EASTON MD
21601-6910
US

V. Phone/Fax

Practice location:
  • Phone: 410-924-8254
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MRS. ANNE MCCAULEY
Title or Position: OWNER/THERAPIST
Credential: LCSW-C
Phone: 410-924-8254