Provider Demographics
NPI:1932862000
Name:STATE OF MIND HEALTH & WELLNESS, LLC
Entity Type:Organization
Organization Name:STATE OF MIND HEALTH & WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHAUNDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:PARSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP-PMH/RN
Authorized Official - Phone:410-705-4422
Mailing Address - Street 1:7933 ANNAPOLIS RD # 1054
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-1309
Mailing Address - Country:US
Mailing Address - Phone:410-705-4422
Mailing Address - Fax:205-855-0617
Practice Address - Street 1:7933 ANNAPOLIS RD # 1054
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-1309
Practice Address - Country:US
Practice Address - Phone:410-705-4422
Practice Address - Fax:205-855-0617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-15
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty