Active Mindz, LLC.

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

ACTIVE MINDZ, LLC.

Doing business as

Active Mindz, LLC.

Practice address

205 River Way Court
Apt. 202
Owings Mills, MD 21117

Phone

(410) 967-6873

NPI assigned

Jan 24, 2023

Last updated

Jan 24, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Brian Wilson, LCSW-CNPI 1427536580

Title

Clinical Therapist

Phone

(410) 967-6873

Specialties & licenses 1

Addresses

Other names 1

• Active Mindz, LLC. Doing business as

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.

• Brian Wilson

  • Social Worker
  • Baltimore, MD
  • NPI 1427536580
  NPD Authorized official

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

{
    "created_epoch": "1674518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674518400000",
    "number": "1164138285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 RIVER WAY COURT",
            "address_2": "APT. 202",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "21117",
            "telephone_number": "410-967-6873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 RIVER WAY COURT",
            "address_2": "APT. 202",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "21117",
            "telephone_number": "410-967-6873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE MINDZ, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-24",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "CLINICAL THERAPIST",
        "authorized_official_telephone_number": "410-967-6873",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW-C"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Active Mindz, LLC.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Amber Michelle Adami, MOT, OTR/L
• Ariel Adams, LCPC

• Mental Health Clinic/Center (Including Community Mental Health Center) in Owings Mills, MD
• Providers in Owings Mills, MD by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2023; 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.