Provider Demographics
NPI:1144955006
Name:MINDWORK GROUP, LLC
Entity type:Organization
Organization Name:MINDWORK GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT/COO
Authorized Official - Prefix:DR
Authorized Official - First Name:MARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:NIKHINSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:443-722-6492
Mailing Address - Street 1:2 HAMILL RD STE 320
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21210-1813
Mailing Address - Country:US
Mailing Address - Phone:443-722-6492
Mailing Address - Fax:
Practice Address - Street 1:2 HAMILL RD STE 320
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21210-1813
Practice Address - Country:US
Practice Address - Phone:443-722-6492
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-23
Last Update Date:2022-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health