Provider Demographics
NPI:1639946635
Name:MIND HEALTH PC
Entity Type:Organization
Organization Name:MIND HEALTH PC
Other - Org Name:MIND HELP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ISMAIL
Authorized Official - Middle Name:M
Authorized Official - Last Name:KALOKOH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-233-5054
Mailing Address - Street 1:1709 KINGS MANOR DR
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-2001
Mailing Address - Country:US
Mailing Address - Phone:301-233-5054
Mailing Address - Fax:301-218-1908
Practice Address - Street 1:1647 BENNING RD NE STE 304
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-4588
Practice Address - Country:US
Practice Address - Phone:301-233-5054
Practice Address - Fax:301-218-1908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-08
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction MedicineGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty