Provider Demographics
NPI:1386531994
Name:MIND AND BODY PYSCHIACTRIC AND MEDICAL SERVICES PLLC
Entity type:Organization
Organization Name:MIND AND BODY PYSCHIACTRIC AND MEDICAL SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ABIGAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:MENSAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-660-6907
Mailing Address - Street 1:5510 CHEROKEE AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22312-2320
Mailing Address - Country:US
Mailing Address - Phone:540-358-8809
Mailing Address - Fax:707-736-7193
Practice Address - Street 1:5510 CHEROKEE AVE STE 300
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22312-2320
Practice Address - Country:US
Practice Address - Phone:540-358-8809
Practice Address - Fax:707-736-7193
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-18
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty