BODY MIND & SOUL FAMILY SERVICES LLC NPI 1508428541

NPI Information

  • NPI: 1508428541
  • Provider Name: BODY MIND & SOUL FAMILY SERVICES, LLC
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Organization
  • Address: 1401 MADISON PARK DR STE 201
    GLEN BURNIE, MD
    ZIP 21061
  • Phone: (240) 620-6883

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NPI Details

BODY MIND & SOUL FAMILY SERVICES, LLC is a psychiatric/mental health nurse practitioner in Glen Burnie, MD. BODY MIND & SOUL FAMILY SERVICES, LLC NPI is 1508428541. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1401 MADISON PARK DR STE 201
GLEN BURNIE, MD
ZIP 21061-881
Phone: (240) 620-6883

The provider's authorized official is Bobbi Howard .
The authorized official title is Director and has the following contact phone number (667) 325-7036.

The enumeration date for this NPI number is 6/30/2019 and was last updated on 10/8/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP0808XNurse PractitionerPsychiatric/Mental HealthYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1110595700MEDICAIDMARYLAND

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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