=====================================================
General NPI Number Information
=====================================================
NPI Number | 1093649105
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TENDER MIND & SOUL HEALTHCARE SERVICES LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/12/2026
-----------------------------------------------------
Last Update Date | 06/12/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 872 ELMWOOD CT
-----------------------------------------------------
City | WESTMINSTER
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21158-8848
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 240-714-9910
-----------------------------------------------------
Fax | 240-714-9910
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 30 S RITTERS LN
-----------------------------------------------------
City | OWINGS MILLS
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21117-3314
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 240-714-9910
-----------------------------------------------------
Fax | 240-714-9910
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MEDICAL DIRECTOR
-----------------------------------------------------
Name | DEBORAH OLUWAKEMI BAMIDELE-FALUSI
-----------------------------------------------------
Credential | CRNP-PMH BC
-----------------------------------------------------
Telephone | 240-714-9910
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------