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General NPI Number Information
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NPI Number | 1386455012
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Entity Type | Organization
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Legal Business Name | TWO MINDS CONNECT, LLC
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Dates
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Enumeration Date | 01/14/2025
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Last Update Date | 05/24/2025
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Provider Practice Location Address
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Address Line | 1655 FORT MYER DR STE 717
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City | ARLINGTON
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State | VA
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Zip | 22209-3113
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Country | US
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Telephone | 617-820-3196
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Fax |
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Provider Business Mailing Address
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Address Line | 7333 NEW HAMPSHIRE AVE APT 214S
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City | TAKOMA PARK
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State | MD
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Zip | 20912-6959
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Country | US
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Telephone | 720-819-3064
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | ZYAIRE TAYLOR
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Credential | RN
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Telephone | 720-819-3064
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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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 | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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