| Empowering Minds Resource Center | |
|
1800 N Charles St Ste 600 Baltimore MD 21201-5990 | |
| (410) 625-5088 | |
| Not Available |
| Full Name | Empowering Minds Resource Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 1800 N Charles St Ste 600, Baltimore, Maryland |
| Authorized Official Name and Position | Tiffinie Carroll (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 4103633713 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Empowering Minds Resource Center 10451 Mill Run Cir # 407 Owings Mills MD 21117-5577 Ph: (443) 925-4897 | Empowering Minds Resource Center 1800 N Charles St Ste 600 Baltimore MD 21201-5990 Ph: (410) 625-5088 |
| NPI Number | 1245874338 |
|---|---|
| Provider Enumeration Date | 10/31/2019 |
| Last Update Date | 06/13/2022 |
| Certification Date | 06/13/2022 |
| Medicare PECOS PAC ID | 2062821929 |
|---|---|
| Medicare Enrollment ID | O20210505000206 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245874338 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Bobbie Nnodim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649821166 PECOS PAC ID: 5395177794 Enrollment ID: I20191122000511 |
| Provider Name | Deborah G Adedeji |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811183973 PECOS PAC ID: 6507288859 Enrollment ID: I20200707000090 |
| Provider Name | Syreeta Byrd |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770060501 PECOS PAC ID: 6800205774 Enrollment ID: I20210505000540 |
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