Provider Demographics
NPI:1275405128
Name:BRIGHT MIND MENTAL HEALTH CLINIC LLC
Entity type:Organization
Organization Name:BRIGHT MIND MENTAL HEALTH CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GODWINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ODIGIE
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:443-244-3099
Mailing Address - Street 1:9331 LIBERTY RD STE 2A
Mailing Address - Street 2:
Mailing Address - City:RANDALLSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21133-3525
Mailing Address - Country:US
Mailing Address - Phone:443-244-3099
Mailing Address - Fax:
Practice Address - Street 1:9331 LIBERTY RD STE 2A
Practice Address - Street 2:
Practice Address - City:RANDALLSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21133-3525
Practice Address - Country:US
Practice Address - Phone:443-244-3099
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-20
Last Update Date:2025-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty