Active NPI
Mentally Evolved LLC
- Psychiatric/Mental Health Nurse Practitioner
- Towson, MD
National Provider Identifier
1215841804
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- Legal business name
- MENTALLY EVOLVED LLC
- Practice address
- 100 West Rd Ste 300
Towson, MD 21204-2370 - Phone
- (410) 832-7000
- NPI assigned
- Sep 30, 2026
- Last updated
- Sep 30, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Tyies Alexander Goines, MSN, CRNP-PMH
- Title
- CRNP-PMH
- Phone
- (443) 939-4422
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | NU | Primary |
Addresses
Primary practice location
100 West Rd Ste 300
Towson, MD 21204-2370
Mailing address
100 West Rd Ste 300
PMB 17673455
Towson, MD 21204-2370
Phone (443) 939-4422
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1790726400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1790726400000",
"number": "1215841804",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 WEST RD STE 300",
"address_2": "PMB 17673455",
"city": "TOWSON",
"state": "MD",
"postal_code": "212042370",
"telephone_number": "443-939-4422"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 WEST RD STE 300",
"city": "TOWSON",
"state": "MD",
"postal_code": "212042370",
"telephone_number": "410-832-7000"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MENTALLY EVOLVED LLC",
"organizational_subpart": "NO",
"enumeration_date": "2026-09-30",
"last_updated": "2026-09-30",
"certification_date": "2026-09-27",
"status": "A",
"authorized_official_last_name": "GOINES",
"authorized_official_first_name": "TYIES",
"authorized_official_middle_name": "ALEXANDER",
"authorized_official_title_or_position": "CRNP-PMH",
"authorized_official_telephone_number": "443-939-4422",
"authorized_official_name_prefix": "Mrs.",
"authorized_official_credential": "MSN, CRNP-PMH"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"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 Sep 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.