# N.E. BEAUTIFUL MIND, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407576853
- **Authorized official:** MRS. JERNAE DICKENS LPC, NCC (OWNER/CLINICAL THERAPIST)
- **Authorized official phone:** (301) 640-0300

## Contact information

- **Practice address:** 1050 30TH ST NW \# 107, WASHINGTON, DC 20007-3822
- **Practice address phone:** (301) 640-0300
- **Mailing address:** 3210 WINTERBOURNE DR, UPPER MARLBORO, MD 20774-9084
- **Mailing address phone:** (202) 246-8323

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0850X | Adult Mental Health Clinic/Center | — | NULL | — |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/29/2022
- **Last updated:** 11/09/2022