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General NPI Number Information
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NPI Number | 1932862000
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Entity Type | Organization
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Legal Business Name | STATE OF MIND HEALTH & WELLNESS, LLC
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Dates
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Enumeration Date | 10/15/2021
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Last Update Date | 02/23/2024
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Provider Practice Location Address
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Address Line | 7933 ANNAPOLIS RD # 1054
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City | LANHAM
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State | MD
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Zip | 20706-1309
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Country | US
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Telephone | 410-705-4422
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Fax | 205-855-0617
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Provider Business Mailing Address
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Address Line | 7933 ANNAPOLIS RD # 1054
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City | LANHAM
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State | MD
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Zip | 20706-1309
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Country | US
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Telephone | 410-705-4422
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Fax | 205-855-0617
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Authorized Official
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Title or Position | OWNER
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Name | SHAUNDRA PARSLEY
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Credential | CRNP-PMH/RN
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Telephone | 410-705-4422
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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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