The Elevated Mind Collective LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

THE ELEVATED MIND COLLECTIVE LLC

Practice address

9574 Killenney PL
Waldorf, MD 20601-3849

Phone

(571) 474-2750

NPI assigned

Jul 31, 2025

Organization subpart

No

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

Authorized official

Name

Dr. Tiffany Michelle Perry-Wilson, PHD, LPC, LCPC, NCCNPI 1265920219

Title

Chief Executive Officer/Owner

Phone

(571) 587-4844

Specialties & licenses 1

Addresses

Practitioners 1

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

• Tiffany Perry-Wilson, PHD, LPC, LCPC, NCC

  • Mental Health Counselor
  • Waldorf, MD
  • NPI 1265920219
  NPD Authorized official

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

{
    "created_epoch": "1753920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780185600000",
    "number": "1497639850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9574 KILLENNEY PL",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206013849",
            "telephone_number": "571-587-4844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9574 KILLENNEY PL",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206013849",
            "telephone_number": "571-474-2750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE ELEVATED MIND COLLECTIVE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-31",
        "last_updated": "2026-05-31",
        "certification_date": "2026-05-31",
        "status": "A",
        "authorized_official_last_name": "PERRY-WILSON",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER/OWNER",
        "authorized_official_telephone_number": "571-587-4844",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, LPC, LCPC, NCC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Waldorf, MD
• Providers in Waldorf, MD by specialty
• Mental Health Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2026; 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.