| Wise Mind, Llc | |
|
90 Painters Mill Rd Ste 203 Owings Mills MD 21117-3614 | |
| (410) 413-4108 | |
| (410) 510-1505 |
| Full Name | Wise Mind, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 90 Painters Mill Rd Ste 203, Owings Mills, Maryland |
| Authorized Official Name and Position | Sharon T Davis (OWNER) |
| Authorized Official Contact | 4104134108 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wise Mind, Llc 90 Painters Mill Rd Ste 203 Owings Mills MD 21117-3614 Ph: (410) 413-4108 | Wise Mind, Llc 90 Painters Mill Rd Ste 203 Owings Mills MD 21117-3614 Ph: (410) 413-4108 |
| NPI Number | 1275054793 |
|---|---|
| Provider Enumeration Date | 07/06/2017 |
| Last Update Date | 01/20/2022 |
| Certification Date | 01/20/2022 |
| Medicare PECOS PAC ID | 9436496676 |
|---|---|
| Medicare Enrollment ID | O20190128000091 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275054793 | NPI | - | NPPES |
| Provider Name | Monica Hardy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619404381 PECOS PAC ID: 9436420320 Enrollment ID: I20170811000298 |
| Provider Name | Atina L Sullivan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508351024 PECOS PAC ID: 2961751722 Enrollment ID: I20180828001601 |
| Provider Name | Sharon Davis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902358070 PECOS PAC ID: 7517204753 Enrollment ID: I20190128000151 |
| Provider Name | Sherry Haywood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992452387 PECOS PAC ID: 3476920059 Enrollment ID: I20221110003199 |
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