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NPI 1619760394

NPI 1619760394 : BEAUTIFUL HEARTS AND MINDS HEALTH AND WELLNESS : GWYNN OAK, MD

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General NPI Number Information
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    NPI Number           |    1619760394
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    Entity Type          |    Organization 
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    Legal Business Name  |    BEAUTIFUL HEARTS AND MINDS HEALTH AND WELLNESS 
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Dates
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    Enumeration Date     |    05/27/2025
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    Last Update Date     |    05/27/2025
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Provider Practice Location Address
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    Address Line         |    1826 WOODLAWN DR STE 6 
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    City                 |    GWYNN OAK
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    State                |    MD
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    Zip                  |    21207-4050
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    Country              |    US
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    Telephone            |    443-813-9961
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1412 N ROLLING RD 
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    City                 |    CATONSVILLE
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    State                |    MD
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    Zip                  |    21228-1103
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    Country              |    US
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    Telephone            |    443-813-9961
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     LAKESHA  ROSS 
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    Credential           |    
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    Telephone            |    443-813-9961
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    261QH0100X
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    Taxonomy Name        |    Health Service 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        |    261QM0855X
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    Taxonomy Name        |    Adolescent and Children Mental Health 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        |    261QP2300X
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    Taxonomy Name        |    Primary Care Clinic/Center
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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        |    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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