NPIMap

Organization Active NPI

Mindwell Therapy Group

  • Mental Health Counselor
  • Baltimore, MD
National Provider Identifier
1225890262
Registry record updated Jan 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
MINDWELL THERAPY GROUP
Practice address
1075 Wilmington Ave
Baltimore, MD 21223-3253
Phone
(443) 682-5678
NPI assigned
Jan 25, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2024

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

Authorized official

Name
Ariel Shashana Ervin, LCSW-CNPI 1891387486
Title
Ceo/Founder
Phone
(443) 682-5678

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 1

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

Addresses

Primary practice location

1075 Wilmington Ave
Baltimore, MD 21223-3253

Mailing address

1075 Wilmington Ave
Baltimore, MD 21223-3253
Phone (443) 682-5678

Other names 1

  • Mindwell Therapy Group Former legal business name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1706140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706486400000",
    "number": "1225890262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1075 WILMINGTON AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212233253",
            "telephone_number": "443-682-5678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 WILMINGTON AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212233253",
            "telephone_number": "443-682-5678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDWELL THERAPY GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-25",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A",
        "authorized_official_last_name": "ERVIN",
        "authorized_official_first_name": "ARIEL",
        "authorized_official_middle_name": "SHASHANA",
        "authorized_official_title_or_position": "CEO/FOUNDER",
        "authorized_official_telephone_number": "443-682-5678",
        "authorized_official_credential": "LCSW-C"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mindwell Therapy Group",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2024; 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.