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General NPI Number Information
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NPI Number | 1629769088
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Entity Type | Organization
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Legal Business Name | WISE MIND, LLC
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Dates
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Enumeration Date | 05/17/2023
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Last Update Date | 10/09/2025
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Provider Practice Location Address
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Address Line | 10711 RED RUN BLVD STE 101
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City | OWINGS MILLS
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State | MD
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Zip | 21117-5138
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Country | US
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Telephone | 443-492-8557
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Fax | 410-510-1505
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Provider Business Mailing Address
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Address Line | 10711 RED RUN BLVD STE 101
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City | OWINGS MILLS
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State | MD
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Zip | 21117-5138
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Country | US
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Telephone | 443-492-8557
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Fax | 410-510-1505
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Authorized Official
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Title or Position | OWNER
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Name | SHARON T DAVIS
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Credential |
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Telephone | 410-413-4108
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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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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