Provider Demographics
NPI:1114788999
Name:PEACEFUL MIND MENTAL HEALTH LLC
Entity Type:Organization
Organization Name:PEACEFUL MIND MENTAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:CANDICE
Authorized Official - Middle Name:FELIZ
Authorized Official - Last Name:POWELL
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:202-449-2180
Mailing Address - Street 1:10770 COLUMBIA PIKE
Mailing Address - Street 2:SUITE 300 #1038
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20901
Mailing Address - Country:US
Mailing Address - Phone:202-449-2180
Mailing Address - Fax:850-407-9743
Practice Address - Street 1:10770 COLUMBIA PIKE
Practice Address - Street 2:SUITE 300 #1038
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20901
Practice Address - Country:US
Practice Address - Phone:202-449-2180
Practice Address - Fax:850-407-9743
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-19
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty