Healthcare Provider Details

I. General information

NPI: 1629906516
Provider Name (Legal Business Name): NURTURING MINDS HEALTH AND WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 MONTGOMERY DR STE 10
NORTH EAST MD
21901-3817
US

IV. Provider business mailing address

9026 LIBERTY RD STE 102
RANDALLSTOWN MD
21133-3900
US

V. Phone/Fax

Practice location:
  • Phone: 443-352-7077
  • Fax: 443-214-2199
Mailing address:
  • Phone: 443-352-7077
  • Fax: 443-214-2199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY MONIQUE JONES
Title or Position: CEO
Credential: LGPC, LGADC
Phone: 443-352-7077