N.E. Beautiful Mind, LLC

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

Legal business name

N.E. BEAUTIFUL MIND, LLC

Practice address

1050 30TH St NW # 107
Washington, DC 20007-3822

Phone

(301) 640-0300

NPI assigned

Aug 29, 2022

Organization subpart

No

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

Authorized official

Name

Mrs. Jernae Dickens, LPC, NCC

Title

Owner/Clinical Therapist

Phone

(301) 640-0300

Specialties & licenses 2

Addresses

Other identifiers 3

Electronic endpoints 2

Locations

Practitioners 1

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

• Jernae Dickens-Brown

  • Mental Health Counselor
  • Washington, DC
  • NPI 1235601337
  NPD

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

{
    "created_epoch": "1661731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667952000000",
    "number": "1407576853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3210 WINTERBOURNE DR",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207749084",
            "telephone_number": "202-246-8323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 30TH ST NW # 107",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200073822",
            "telephone_number": "301-640-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "N.E. BEAUTIFUL MIND, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-29",
        "last_updated": "2022-11-09",
        "certification_date": "2022-11-09",
        "status": "A",
        "authorized_official_last_name": "DICKENS",
        "authorized_official_first_name": "JERNAE",
        "authorized_official_title_or_position": "OWNER/CLINICAL THERAPIST",
        "authorized_official_telephone_number": "301-640-0300",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPC, NCC"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DC2022",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS & BLUE SHEILD",
            "identifier": "BCBS2022",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "UHC2022",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@nebeautifulmind.com",
            "affiliation": "N",
            "address_1": "3210 Winterbourne Dr",
            "city": "Upper Marlboro",
            "state": "MD",
            "country_code": "US",
            "postal_code": "207749084",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "info@nebeautifulmind.com",
            "affiliation": "N",
            "endpointDescription": "business email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1050 30th St NW # 107",
            "city": "Washington",
            "state": "DC",
            "country_code": "US",
            "postal_code": "200073822",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• All providers in Washington, DC
• Adolescent and Children Mental Health Clinic/Center in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2022; 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.