Healthcare Provider Details

I. General information

NPI: 1467267245
Provider Name (Legal Business Name): MARYLAND MINDFULNESS AND MENTAL PERFORMANCE COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2025
Last Update Date: 04/22/2025
Certification Date: 04/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 THAYER CTR STE C
OAKLAND MD
21550-1139
US

IV. Provider business mailing address

3607 GARDENVIEW RD
PIKESVILLE MD
21208-1511
US

V. Phone/Fax

Practice location:
  • Phone: 301-523-2017
  • Fax:
Mailing address:
  • Phone: 301-523-2017
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SARAH CAROLINE SPUND
Title or Position: THERAPIST
Credential: LCPC
Phone: 301-523-2017