Provider Demographics
NPI:1275232571
Name:CALM MINDS HEALING CENTER, LLC
Entity Type:Organization
Organization Name:CALM MINDS HEALING CENTER, LLC
Other - Org Name:CALM MINDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER, CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:A
Authorized Official - Last Name:LEDERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LGPC
Authorized Official - Phone:443-252-3369
Mailing Address - Street 1:12310 LOU CT
Mailing Address - Street 2:
Mailing Address - City:BISHOPVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21813-1105
Mailing Address - Country:US
Mailing Address - Phone:443-359-1840
Mailing Address - Fax:
Practice Address - Street 1:617 FRANKLIN AVE # 19
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:MD
Practice Address - Zip Code:21811-1358
Practice Address - Country:US
Practice Address - Phone:443-252-3369
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-27
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)