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General NPI Number Information
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NPI Number | 1366256240
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Entity Type | Organization
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Legal Business Name | IMIND HEALTH LLC
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Dates
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Enumeration Date | 02/03/2025
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Last Update Date | 02/03/2025
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Provider Practice Location Address
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Address Line | 1802 BRIGHTSEAT RD STE 300
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City | HYATTSVILLE
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State | MD
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Zip | 20785-4244
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Country | US
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Telephone | 240-249-0989
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Fax |
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Provider Business Mailing Address
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Address Line | 1802 BRIGHTSEAT RD STE 300
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City | HYATTSVILLE
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State | MD
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Zip | 20785-4244
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Country | US
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Telephone | 240-249-0989
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Fax |
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Authorized Official
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Title or Position | CHIEF OPERATION OFFICER
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Name | KHANH-LINH FLYNN
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Credential |
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Telephone | 240-249-0989
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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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 | 163WA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Registered Nurse
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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