Organization · Type 2 NPI
Supportive Minds Mental Health Services, LLC
Psychiatric/Mental Health Nurse Practitioner · Montgomery Village, MD
NPI number
1609781640
Active
Practice location
19650 Club House Rd Ste 202A
Montgomery Village, MD 20886-3003
Mailing address
11273 Suffolk Dr
Hagerstown, MD 21742-4054
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatry Physician | 2084P0800X | None listed |
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | None listed |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1609781640
Supportive Minds Mental Health Services, LLC's National Provider Identifier is 1609781640, issued on Aug 15, 2026. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Montgomery Village, MD. The record was last updated on Oct 23, 2026.