NPIMap

Organization Active NPI

Mindfulbalanced Psychiatric LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Owings Mills, MD
National Provider Identifier
1932926102
Registry record updated Jul 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
MINDFULBALANCED PSYCHIATRIC LLC
Practice address
10711 Red Run Blvd Ste 101
Owings Mills, MD 21117-5138
Phone
(443) 264-1250
Fax
(855) 613-0989
NPI assigned
Sep 20, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2025

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

Authorized official

Name
Adanna IkwuegbuNPI 1982473625
Title
Owner
Phone
(443) 449-3941

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

10711 Red Run Blvd Ste 101
Owings Mills, MD 21117-5138

Mailing address

9722 Groffs Mill Dr Ste 1040
Owings Mills, MD 21117-6341
Phone (443) 449-3941

Other practice location 1

9506 Lyonswood Dr
Owings Mills, MD 21117-4714
Phone (443) 449-3941

Other practice location 2

1050 Connecticut Ave NW # 5005
Washington, DC 20036-5303
Phone (443) 264-1250

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241004000417 MD Part B Supplier - Clinic/Group Practice 7911438742 Receives reassigned benefits from 2 practitioners
Practice locations: Owings Mills, MD

National Provider Directory

National Provider Directory

Locations

1050 Connecticut Ave NW
#5005
Washington, DC 20036
Phone (443) 264-1250

Practitioners & affiliated clinicians

Practitioners 2

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": "1726790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751328000000",
    "number": "1932926102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9722 GROFFS MILL DR STE 1040",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211176341",
            "telephone_number": "443-449-3941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10711 RED RUN BLVD STE 101",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211175138",
            "telephone_number": "443-264-1250",
            "fax_number": "855-613-0989"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9506 Lyonswood Dr",
            "address_purpose": "LOCATION",
            "city": "Owings Mills",
            "state": "MD",
            "postal_code": "211174714",
            "country_code": "US",
            "telephone_number": "443-449-3941",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1050 Connecticut Ave NW # 5005",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200365303",
            "country_code": "US",
            "telephone_number": "443-264-1250",
            "fax_number": "855-613-0989",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MINDFULBALANCED PSYCHIATRIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-20",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A",
        "authorized_official_last_name": "IKWUEGBU",
        "authorized_official_first_name": "ADANNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "443-449-3941"
    },
    "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 Owings Mills, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2025; 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.