NPIMap

Organization Active NPI

Mind Over Matter Health Services, Inc

  • Community/Behavioral Health Agency
  • Randallstown, MD
National Provider Identifier
1003565979
Registry record updated Mar 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
MIND OVER MATTER HEALTH SERVICES, INC
Practice address
10016 Marriottsville Rd
Randallstown, MD 21133-1502
Phone
(443) 405-1095
NPI assigned
Mar 19, 2022
Organization subpart
Yes
Parent organization
ASIA JOHNSONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 19, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Asia Johnson, LCPC
Title
Practitioner/Administrator
Phone
(410) 982-1353

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Developmentally Disabled Services Day Training Agency 251C00000X
Community/Behavioral Health Agency 251S00000X Primary
Community Health Clinic/Center 261QC1500X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Multi-Specialty Clinic/Center 261QM1300X
Children's Substance Abuse Rehabilitation Facility 3245S0500X

Addresses

Primary practice location

10016 Marriottsville Rd
Randallstown, MD 21133-1502

Mailing address

10016 Marriottsville Rd
Randallstown, MD 21133-1502

Other identifiers 1

IdentifierTypeStateIssuer
300269100MedicaidMD

Other names 1

  • Asia Johnson LCPC Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL thegoodreboot.com Direct

National Provider Directory

National Provider Directory
Tax ID family
Mind Over Matter Health Services Inc4 organizations share this tax ID, including this one
Part of
Asia Al-Mateen LCPC Acs

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1647648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647648000000",
    "number": "1003565979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10016 MARRIOTTSVILLE RD",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211331502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10016 MARRIOTTSVILLE RD",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211331502",
            "telephone_number": "443-405-1095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND OVER MATTER HEALTH SERVICES, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ASIA JOHNSON",
        "enumeration_date": "2022-03-19",
        "last_updated": "2022-03-19",
        "certification_date": "2022-03-19",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "ASIA",
        "authorized_official_title_or_position": "PRACTITIONER/ADMINISTRATOR",
        "authorized_official_telephone_number": "410-982-1353",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300269100",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "thegoodreboot.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "PHI",
            "address_1": "10016 Marriottsville Rd",
            "city": "Randallstown",
            "state": "MD",
            "country_code": "US",
            "postal_code": "211331502",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Asia Johnson LCPC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Randallstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.