| Healthy Minds Llc | |
|
9114 Philadelphia Rd Ste 106 Rosedale MD 21237-4346 | |
| (240) 468-8476 | |
| Not Available |
| Full Name | Healthy Minds Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 9114 Philadelphia Rd Ste 106, Rosedale, Maryland |
| Authorized Official Name and Position | Jacquette Jacobs (CEO) |
| Authorized Official Contact | 2404688476 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Healthy Minds Llc 2919 Cub Hill Rd Parkville MD 21234-1126 Ph: (240) 468-8476 | Healthy Minds Llc 9114 Philadelphia Rd Ste 106 Rosedale MD 21237-4346 Ph: (240) 468-8476 |
| NPI Number | 1437885795 |
|---|---|
| Provider Enumeration Date | 07/28/2022 |
| Last Update Date | 09/06/2023 |
| Certification Date | 07/28/2022 |
| Medicare PECOS PAC ID | 5193199198 |
|---|---|
| Medicare Enrollment ID | O20230314001820 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437885795 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Barry Uzoechi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134874233 PECOS PAC ID: 6709252034 Enrollment ID: I20221012000195 |
| Provider Name | Joyce Jackson Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083225403 PECOS PAC ID: 4587038583 Enrollment ID: I20230314002106 |
| Provider Name | Rashidat Olayinka Odunewu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780332874 PECOS PAC ID: 2668839986 Enrollment ID: I20230601000689 |
| Provider Name | Catherine Minimadey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063151454 PECOS PAC ID: 1658738539 Enrollment ID: I20230608000482 |
| Provider Name | Jacquette Jacobs |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1386996866 PECOS PAC ID: 9638543630 Enrollment ID: I20240108000056 |
| Provider Name | Vickie Cooke |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1306203880 PECOS PAC ID: 8628421765 Enrollment ID: I20240125001321 |
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