Light And Mind Wellness LLC
Nurse Practitioner, Psych/Mental Health in Easton, MD. Organization (NPI-2).
NPI number1609449677
StatusActive
Last updated in NPPESJan 25, 2025
Details
- NPI
- 1609449677
- Entity type
- Organization (NPI-2)
- Legal business name
- Light And Mind Wellness LLC
- Organization subpart
- No
- Enumeration date
- Jul 19, 2021
- Certification date
- Jan 25, 2025
- Last updated
- Jan 25, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | – | – | Yes |
| 261QM0801X | Clinic/Center, Mental Health (Including Community Mental Health Center) | – | – | |
| 261QM0850X | Clinic/Center, Adult Mental Health | – | – | |
| 261QM0855X | Clinic/Center, Adolescent and Children Mental Health | – | – | |
| 363L00000X | Nurse Practitioner | – | – |
Other names
- Light And Mind Wellness LLC (Other Name)
Practice location
8707 Commerce Dr Ste EEaston, MD 21601-6910
Phone 410-855-4664 · Fax 855-461-3481
Mailing address
8707 Commerce Dr Ste EEaston, MD 21601-6910
Phone 443-239-2033 · Fax 855-461-3481
Other practice locations
811 N Broad St Ste 225a
Middletown, DE 19709-1173
Middletown, DE 19709-1173
Phone 443-239-2033 · Fax 855-461-3481
Authorized official
Aisha Hassan-Davis
Owner/Provider
4432392033
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Other Psychiatric/Mental Health Nurse Practitioner providers in Easton, MD
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All 22 Psychiatric/Mental Health Nurse Practitioner providers in Easton · All 1,420 providers in Easton
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