Organization Active NPI

Wise Mind Behavioral Health

  • Mental Health Counselor
  • Frederick, MD
National Provider Identifier
1023791258
Registry record updated Dec 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
WISE MIND BEHAVIORAL HEALTH
Practice address
176 Thomas Johnson Dr Ste 204
Frederick, MD 21702-4538
Phone
(240) 608-2307
NPI assigned
Aug 14, 2023
Last updated
Dec 28, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2025

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

Authorized official

Name
Matthew Goodwin, LCPCNPI 1780080531
Title
Owner
Phone
(240) 608-2307

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU Primary
Clinical Social Worker 1041C0700X NU
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU

Addresses

Primary practice location

176 Thomas Johnson Dr Ste 204
Frederick, MD 21702-4538

Mailing address

176 Thomas Johnson Dr
Frederick, MD 21702-4410
Phone (240) 608-2307

National Provider Directory

National Provider Directory

Locations

176 Thomas Johnson Dr
Frederick, MD 21702
Phone (301) 471-1705

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1691971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766880000000",
    "number": "1023791258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "176 THOMAS JOHNSON DR",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024410",
            "telephone_number": "240-608-2307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "176 THOMAS JOHNSON DR STE 204",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024538",
            "telephone_number": "240-608-2307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISE MIND BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-14",
        "last_updated": "2025-12-28",
        "certification_date": "2025-12-28",
        "status": "A",
        "authorized_official_last_name": "GOODWIN",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "240-608-2307",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2025; 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.