Healthcare Provider Details

I. General information

NPI: 1265921647
Provider Name (Legal Business Name): IMIND HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2018
Last Update Date: 10/13/2025
Certification Date: 10/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4640 FORBES BLVD # 375
LANHAM MD
20706-4323
US

IV. Provider business mailing address

4640 FORBES BLVD # 375
LANHAM MD
20706-4323
US

V. Phone/Fax

Practice location:
  • Phone: 240-249-0989
  • Fax: 240-256-8887
Mailing address:
  • Phone: 240-249-0989
  • Fax: 240-256-8887

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code364SP0810X
TaxonomyChild & Family Psychiatric/Mental Health Clinical Nurse Specialist
License Number
License Number State

VIII. Authorized Official

Name: KHANH-LINH FLYNN
Title or Position: MANAGING PARTNER
Credential:
Phone: 703-395-2109