Provider Demographics
NPI:1740856657
Name:INNOVATIVE MINDSET MENTAL HEALTH SERVICES
Entity type:Organization
Organization Name:INNOVATIVE MINDSET MENTAL HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:OLUWATOSIN
Authorized Official - Middle Name:O
Authorized Official - Last Name:AROWOSEGBE
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP-PMHNP
Authorized Official - Phone:240-795-1746
Mailing Address - Street 1:4 S MCCAIN DR STE 9
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21703-6093
Mailing Address - Country:US
Mailing Address - Phone:240-795-1746
Mailing Address - Fax:
Practice Address - Street 1:4 S MCCAIN DR STE 9
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21703-6093
Practice Address - Country:US
Practice Address - Phone:240-795-1746
Practice Address - Fax:410-304-6166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-01
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty