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General NPI Number Information
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NPI Number | 1740008358
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Entity Type | Organization
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Legal Business Name | MINDFUL MENTAL HEALTH, LLC
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Dates
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Enumeration Date | 10/01/2024
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Last Update Date | 10/02/2024
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Provider Practice Location Address
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Address Line | 5457 TWIN KNOLLS RD STE 300
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City | COLUMBIA
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State | MD
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Zip | 21045-3296
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Country | US
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Telephone | 410-696-5142
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 6021
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City | ELLICOTT CITY
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State | MD
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Zip | 21042-0021
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Country | US
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Telephone | 410-493-6754
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | TEMIKA HEYWARD
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Credential | DNP, PMHNP, FNP
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Telephone | 410-696-5142
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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