MEDICARE: WISE MIND POLICY AND PRACTICE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1962227066
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WISE MIND POLICY AND PRACTICE LLC

Provider Business Mailing Address
First Line	:	2028 GLEN ROSS RD
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20910-2123
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10410 KENSINGTON PKWY STE 312
Second Line	:
City	:	KENSINGTON
State	:	MD
Zip	:	20895-2948
Country	:	US
Telephone Number	:	301-485-9793
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. AMY C GREENE
Credential	:	LCSW-C, MSW
Telephone Number	:	301-789-2822

Provider Enumeration Date	:	11/22/2024
Last Update Date	:	12/05/2025

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