Provider Demographics
NPI:1700233319
Name:HEALING MINDS AND HEARTS SERVICES
Entity type:Organization
Organization Name:HEALING MINDS AND HEARTS SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SABRENA
Authorized Official - Middle Name:
Authorized Official - Last Name:BARNES-MCALLISTER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:240-349-2507
Mailing Address - Street 1:4560 CRAIN HWY
Mailing Address - Street 2:SUITE 5
Mailing Address - City:WHITE PLAINS
Mailing Address - State:MD
Mailing Address - Zip Code:20695-3015
Mailing Address - Country:US
Mailing Address - Phone:240-349-2507
Mailing Address - Fax:301-874-3089
Practice Address - Street 1:4560 CRAIN HWY
Practice Address - Street 2:SUITE 5
Practice Address - City:WHITE PLAINS
Practice Address - State:MD
Practice Address - Zip Code:20695-3015
Practice Address - Country:US
Practice Address - Phone:240-349-2507
Practice Address - Fax:301-874-3089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-24
Last Update Date:2016-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD175061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD098540600Medicaid