Organization Active NPI

State of Mind Health & Wellness, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Lanham, MD
National Provider Identifier
1932862000
Registry record updated Feb 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
STATE OF MIND HEALTH & WELLNESS, LLC
Practice address
7933 Annapolis Rd # 1054
Lanham, MD 20706-1309
Phone
(410) 705-4422
Fax
(205) 855-0617
NPI assigned
Oct 15, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2024

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

Authorized official

Name
Shaundra Parsley, CRNP-PMH/RNNPI 1427688662
Title
Owner
Phone
(410) 705-4422

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

7933 Annapolis Rd # 1054
Lanham, MD 20706-1309

Mailing address

7933 Annapolis Rd # 1054
Lanham, MD 20706-1309
Phone (410) 705-4422

Other practice location 1

7306 Stallings Dr
Glen Burnie, MD 21060-8371
Phone (410) 705-4422

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20220603000149 MD Part B Supplier - Clinic/Group Practice 9032597026 Receives reassigned benefits from 1 practitioner
Practice locations: Glen Burnie, MD
O20230612001336 DC Part B Supplier - Clinic/Group Practice 9032597026 Receives reassigned benefits from 1 practitioner
Practice locations: Lanham, MD

National Provider Directory

National Provider Directory

Locations

8338 Veterans Hwy
Ste 204A
Millersville, MD 21108
Phone (410) 705-4422

Practitioners & affiliated clinicians

Practitioners 4

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": "1634256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708646400000",
    "number": "1932862000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7933 ANNAPOLIS RD # 1054",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207061309",
            "telephone_number": "410-705-4422",
            "fax_number": "205-855-0617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7933 ANNAPOLIS RD # 1054",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207061309",
            "telephone_number": "410-705-4422",
            "fax_number": "205-855-0617"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7306 Stallings Dr",
            "address_purpose": "LOCATION",
            "city": "Glen Burnie",
            "state": "MD",
            "postal_code": "210608371",
            "country_code": "US",
            "telephone_number": "410-705-4422",
            "fax_number": "205-855-0617",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "STATE OF MIND HEALTH & WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-15",
        "last_updated": "2024-02-23",
        "certification_date": "2024-02-23",
        "status": "A",
        "authorized_official_last_name": "PARSLEY",
        "authorized_official_first_name": "SHAUNDRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-705-4422",
        "authorized_official_credential": "CRNP-PMH/RN"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lanham, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2024; 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.