Active NPI
Mindful Journey Wellness, LLC
- Psychiatric/Mental Health Nurse Practitioner
- Frederick, MD
National Provider Identifier
1639076912
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- Legal business name
- MINDFUL JOURNEY WELLNESS, LLC
- Practice address
- 2104 Peace Lily LN
Frederick, MD 21702-1777 - Phone
- (571) 331-4356
- NPI assigned
- Oct 21, 2026
- Last updated
- Oct 21, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Isatu Kanu, PMHNP-BC
- Title
- Ceo
- Phone
- (571) 331-4356
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | Primary |
Addresses
Primary practice location
2104 Peace Lily LN
Frederick, MD 21702-1777
Mailing address
2104 Peace Lily LN
Frederick, MD 21702-1777
Phone (571) 331-4356
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Psychiatric/Mental Health Nurse Practitioner
- Frederick, MD
- NPI 1558202473
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1792540800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1792540800000",
"number": "1639076912",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2104 PEACE LILY LN",
"city": "FREDERICK",
"state": "MD",
"postal_code": "217021777",
"telephone_number": "571-331-4356"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2104 PEACE LILY LN",
"city": "FREDERICK",
"state": "MD",
"postal_code": "217021777",
"telephone_number": "571-331-4356"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MINDFUL JOURNEY WELLNESS, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2026-10-21",
"last_updated": "2026-10-21",
"certification_date": "2026-10-21",
"status": "A",
"authorized_official_last_name": "KANU",
"authorized_official_first_name": "ISATU",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "571-331-4356",
"authorized_official_credential": "PMHNP-BC"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Frederick, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.