NPIMap

Organization Active NPI

Healing Minds Wellness Center, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Baltimore, MD
National Provider Identifier
1295332351
Registry record updated Oct 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
HEALING MINDS WELLNESS CENTER, LLC
Practice address
3600 Pulaski Hwy
Baltimore, MD 21224-1534
Phone
(443) 961-7523
NPI assigned
Oct 2, 2020
Last updated
Oct 2, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2020

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

Authorized official

Name
Kenyona Davis, LMSW
Title
Ceo/President
Phone
(443) 961-7523

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X
Addiction (Substance Use Disorder) Counselor 101YA0400X
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

3600 Pulaski Hwy
Baltimore, MD 21224-1534

Mailing address

3600 Pulaski Hwy
Baltimore, MD 21224-1534
Phone (443) 961-7523

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address admin@healingmindswellness.com Health Information Exchange (HIE)

National Provider Directory

National Provider Directory
Tax ID family
Healing Minds Wellness Center LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1601596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601596800000",
    "number": "1295332351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 PULASKI HWY",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212241534",
            "telephone_number": "443-961-7523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 PULASKI HWY",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212241534",
            "telephone_number": "443-961-7523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALING MINDS WELLNESS CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-02",
        "last_updated": "2020-10-02",
        "certification_date": "2020-10-02",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "KENYONA",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "443-961-7523",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "admin@healingmindswellness.com",
            "affiliation": "N",
            "endpointDescription": "adminstrative email address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3600 Pulaski Hwy # 100",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212241534",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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 Oct 2, 2020; 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.