Provider Demographics
NPI:1255195152
Name:MENTAL WEALTH PSYCHIATRIC SERVICES, INC.
Entity type:Organization
Organization Name:MENTAL WEALTH PSYCHIATRIC SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP-PMH
Authorized Official - Phone:443-345-2275
Mailing Address - Street 1:1910 TOWNE CENTRE BLVD STE 250
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-3599
Mailing Address - Country:US
Mailing Address - Phone:443-345-2275
Mailing Address - Fax:
Practice Address - Street 1:501 E NAYLOR MILL RD UNIT C
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-2278
Practice Address - Country:US
Practice Address - Phone:443-345-2275
Practice Address - Fax:443-300-9504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-12
Last Update Date:2024-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty