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General NPI Number Information
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NPI Number | 1417836636
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Entity Type | Organization
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Legal Business Name | MINDLINK LLC
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Dates
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Enumeration Date | 09/01/2025
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Last Update Date | 09/01/2025
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Provider Practice Location Address
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Address Line | 10440 LITTLE PATUXENT PKWY
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City | COLUMBIA
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State | MD
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Zip | 21044-3561
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Country | US
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Telephone | 325-899-2588
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Fax |
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Provider Business Mailing Address
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Address Line | 10440 LITTLE PATUXENT PKWY
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City | COLUMBIA
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State | MD
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Zip | 21044-3561
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Country | US
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Telephone | 325-899-2588
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Fax |
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. OLUGBUYI DARE FASHOYIN
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Credential | PT
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Telephone | 325-899-2588
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084B0040X
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Taxonomy Name | Behavioral Neurology & Neuropsychiatry Physician
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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 | 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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Taxonomy #3
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Taxonomy Code | 276400000X
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Taxonomy Name | Substance Use Disorder Rehabilitation Hospital Unit
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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 | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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