Healthcare Provider Details

I. General information

NPI: 1881541324
Provider Name (Legal Business Name): NIRVANA MENTAL HEALTHCARE SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2026
Last Update Date: 03/13/2026
Certification Date: 03/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 WATERFRONT ST STE 420
NATIONAL HARBOR MD
20745-1122
US

IV. Provider business mailing address

120 WATERFRONT ST STE 420
NATIONAL HARBOR MD
20745-1122
US

V. Phone/Fax

Practice location:
  • Phone: 240-647-8262
  • Fax: 844-779-2437
Mailing address:
  • Phone: 240-647-8262
  • Fax: 844-779-2437

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: AYANNA WILLIAMS
Title or Position: CHIEF NURSING OFFICER
Credential: NP
Phone: 240-647-8262