Healthcare Provider Details

I. General information

NPI: 1285321638
Provider Name (Legal Business Name): WISE MIND, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2023
Last Update Date: 07/19/2026
Certification Date: 07/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

516 N ROLLING RD STE 305
CATONSVILLE MD
21228-4142
US

IV. Provider business mailing address

516 N ROLLING RD STE 305
CATONSVILLE MD
21228-4142
US

V. Phone/Fax

Practice location:
  • Phone: 443-492-8557
  • Fax: 410-510-1505
Mailing address:
  • Phone: 443-492-8557
  • Fax: 410-510-1505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SHARON T DAVIS
Title or Position: OWNER THERAPIST
Credential: LCSWC
Phone: 410-413-4108