Provider Demographics
NPI:1447072160
Name:WISE MIND THERAPY AND WELLNESS
Entity type:Organization
Organization Name:WISE MIND THERAPY AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:C
Authorized Official - Last Name:GREENE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:301-789-2282
Mailing Address - Street 1:10410 KENSINGTON PARKWAY
Mailing Address - Street 2:SUITE 303
Mailing Address - City:KENSINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20895-2943
Mailing Address - Country:US
Mailing Address - Phone:301-789-2282
Mailing Address - Fax:
Practice Address - Street 1:10410 KENSINGTON PARKWAY #303
Practice Address - Street 2:SUITE 303
Practice Address - City:KENSINGTON
Practice Address - State:MD
Practice Address - Zip Code:20895-2943
Practice Address - Country:US
Practice Address - Phone:301-789-2282
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WISE MIND POLICY AND PRACTICE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-10-25
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty