LIGHT AND MIND WELLNESS LLC NPI 1609449677

NPI Information

  • NPI: 1609449677
  • Provider Name: LIGHT AND MIND WELLNESS LLC
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Organization
  • :
  • Address: 8707 COMMERCE DR STE E
    EASTON, MD
    ZIP 21601
  • Phone: (410) 855-4664

Map and Directions

Get Directions

NPI Details

LIGHT AND MIND WELLNESS LLC is a psychiatric/mental health nurse practitioner in Easton, MD. LIGHT AND MIND WELLNESS LLC NPI is 1609449677. The provider is registered as an organization entity type.
The provider .

The provider's business location address is:

8707 COMMERCE DR STE E
EASTON, MD
ZIP 21601-910
Phone: (410) 855-4664
Fax: (855) 461-3481

The provider's authorized official is Aisha Hassan-davis .
The authorized official title is Owner/provider and has the following contact phone number (443) 239-2033.

The enumeration date for this NPI number is 7/19/2021 and was last updated on 1/25/2025.

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
1261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)No
2261QM0850XClinic/CenterAdult Mental HealthNo
3261QM0855XClinic/CenterAdolescent and Children Mental HealthNo
4363L00000XNurse PractitionerNo
5363LP0808XNurse 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
1250696270MEDICAIDDELAWARE
2206453701MEDICAIDMARYLAND

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: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI
Next NPI