NPIMap

Organization Active NPI

Mind & Soul Telewellness LLC

  • Mental Health Counselor
  • Towson, MD
National Provider Identifier
1205495496
Registry record updated May 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
MIND & SOUL TELEWELLNESS LLC
Practice address
320 E Towsontown Blvd Ste 201
Towson, MD 21286-5331
Phone
(443) 953-8922
Fax
(855) 955-1334
NPI assigned
Jun 11, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2024

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

Authorized official

Name
Toni Ray
Title
Director
Phone
(443) 953-8922

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

320 E Towsontown Blvd Ste 201
Towson, MD 21286-5331

Mailing address

320 E Towsontown Blvd Ste 201
Towson, MD 21286-5331
Phone (443) 953-8922

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL Catonsville
CONNECT URL Pikesville

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191104003125 MD Part B Supplier - Clinic/Group Practice 8123350576 Receives reassigned benefits from 8 practitioners
Practice locations: Towson, MD

National Provider Directory

National Provider Directory

Locations

1430 Reisterstown Rd
Ste 3
Pikesville, MD 21208
Phone (443) 953-8922

320 E Towsontown Blvd
Towson, MD 21286
Phone (410) 424-5946

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1560211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715644800000",
    "number": "1205495496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 E TOWSONTOWN BLVD STE 201",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212865331",
            "telephone_number": "443-953-8922",
            "fax_number": "855-955-1334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 E TOWSONTOWN BLVD STE 201",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212865331",
            "telephone_number": "443-953-8922",
            "fax_number": "855-955-1334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND & SOUL TELEWELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-11",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A",
        "authorized_official_last_name": "RAY",
        "authorized_official_first_name": "TONI",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "443-953-8922"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Catonsville",
            "affiliation": "N",
            "address_1": "724 Maiden Choice Ln Ste 304",
            "city": "Catonsville",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212285967",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Pikesville",
            "affiliation": "N",
            "address_1": "1430 Reisterstown Rd Ste 3",
            "city": "Pikesville",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212083843",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Towson, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.