Healthcare Provider Details

I. General information

NPI: 1215704341
Provider Name (Legal Business Name): BEAUTIFUL MIND MENTAL HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2023
Last Update Date: 11/04/2024
Certification Date: 11/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8201 CORPORATE DR STE 610
HYATTSVILLE MD
20785-2245
US

IV. Provider business mailing address

11311 SHERRINGTON CT
UPPER MARLBORO MD
20774-2317
US

V. Phone/Fax

Practice location:
  • Phone: 240-744-1086
  • Fax: 205-855-0617
Mailing address:
  • Phone: 240-744-1086
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. CANDICE CAESAR
Title or Position: CEO
Credential: PMHNP
Phone: 240-744-1086