Transforming Your Mind, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

TRANSFORMING YOUR MIND, LLC

Practice address

1 E Chase St Ste
209 212 213 215
Baltimor, MD 21202-2526

Phone

(443) 991-1370

NPI assigned

Feb 15, 2023

Last updated

Aug 6, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Formka Johnson, LCSW-CNPI 1861923062

Title

Owner/ Social Worker

Phone

(443) 991-1370

Specialties & licenses 1

Addresses

Locations

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.

• Formka Johnson, LCSW-C

  • Social Worker
  • Baltimore, MD
  • NPI 1861923062
  NPD Authorized official

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

{
    "created_epoch": "1676419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691280000000",
    "number": "1962109488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1113 E PRESTON ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212025621",
            "telephone_number": "443-991-1370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 E CHASE ST STE",
            "address_2": "209 212 213 215",
            "city": "BALTIMOR",
            "state": "MD",
            "postal_code": "212022526",
            "telephone_number": "443-991-1370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRANSFORMING YOUR MIND, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-15",
        "last_updated": "2023-08-06",
        "certification_date": "2023-08-06",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "FORMKA",
        "authorized_official_title_or_position": "OWNER/ SOCIAL WORKER",
        "authorized_official_telephone_number": "443-991-1370",
        "authorized_official_credential": "LCSW-C"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2023; 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.