Provider Demographics
NPI:1093473043
Name:WHOLESOME MINDS, LLC.
Entity Type:Organization
Organization Name:WHOLESOME MINDS, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTI
Authorized Official - Middle Name:G
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:804-349-5792
Mailing Address - Street 1:13854 CARTER HOUSE WAY
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-4855
Mailing Address - Country:US
Mailing Address - Phone:804-349-5792
Mailing Address - Fax:
Practice Address - Street 1:13854 CARTER HOUSE WAY
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-4855
Practice Address - Country:US
Practice Address - Phone:804-349-5792
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-06
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty