Organization Active NPI

Clear Mind Health LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Baltimore, MD
National Provider Identifier
1629582960
Registry record updated Jan 6, 2021
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
CLEAR MIND HEALTH LLC
Practice address
400 E Patapsco Ave
Baltimore, MD 21225-1830
Phone
(240) 432-1276
NPI assigned
Nov 23, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2021

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

Authorized official

Name
Oladipo OlaleyeNPI 1467888529
Title
Pmhnp
Phone
(240) 432-1276

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

400 E Patapsco Ave
Baltimore, MD 21225-1830

Mailing address

12116 Serenity LN
Marriottsville, MD 21104-1458
Phone (240) 432-1276

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210128000028 MD Part B Supplier - Clinic/Group Practice 8820402126 Receives reassigned benefits from 1 practitioner
Practice locations: Baltimore, MD

National Provider Directory

National Provider Directory
Tax ID family
Clear Mind Health2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

400 E Patapsco Ave
Brooklyn, MD 21225
Phone (240) 432-1276

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": "1511395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609891200000",
    "number": "1629582960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12116 SERENITY LN",
            "city": "MARRIOTTSVILLE",
            "state": "MD",
            "postal_code": "211041458",
            "telephone_number": "240-432-1276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E PATAPSCO AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212251830",
            "telephone_number": "240-432-1276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEAR MIND HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-23",
        "last_updated": "2021-01-06",
        "certification_date": "2021-01-06",
        "status": "A",
        "authorized_official_last_name": "OLALEYE",
        "authorized_official_first_name": "OLADIPO",
        "authorized_official_title_or_position": "PMHNP",
        "authorized_official_telephone_number": "240-432-1276"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "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": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 Jan 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.