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General NPI Number Information
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NPI Number | 1053041293
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Entity Type | Organization
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Legal Business Name | MINDSCAPE PSYCH, PLLC
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Dates
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Enumeration Date | 06/11/2022
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Last Update Date | 06/11/2022
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Provider Practice Location Address
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Address Line | 4701 SANGAMORE RD STE N100
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City | BETHESDA
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State | MD
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Zip | 20816-2558
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Country | US
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Telephone | 240-484-4226
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 523
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City | LAUREL
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State | MD
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Zip | 20725-0523
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Country | US
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Telephone | 240-484-4226
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Fax |
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Authorized Official
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Title or Position | PROVIDER
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Name | DR. AMANDA FELIX
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Credential |
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Telephone | 240-484-4226
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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