Provider Demographics
NPI:1952715161
Name:PEACE OF MIND MENTAL HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:PEACE OF MIND MENTAL HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:D
Authorized Official - Last Name:SHORT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:410-690-8181
Mailing Address - Street 1:29315 ERICKSON DRIVE
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601-8651
Mailing Address - Country:US
Mailing Address - Phone:410-690-8181
Mailing Address - Fax:410-690-8185
Practice Address - Street 1:29315 ERICKSON DRIVE
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-8651
Practice Address - Country:US
Practice Address - Phone:410-690-8181
Practice Address - Fax:410-690-8185
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-16
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty