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Organization
LIGHT AND MIND WELLNESS LLC
Active
Organization
LIGHT AND MIND WELLNESS LLC
Active
Other names
Light And Mind WELLNESS LLC
Organization subpart
No
Provider details
NPI number
Authorized official
AISHA HASSAN-DAVIS CNS,PMH-NP, APRN (OWNER/PROVIDER)
(443) 239-2033
Entity
Organization
Contact information
Practice address
8707 COMMERCE DR STE E, EASTON, MD 21601-6910
(410) 855-4664
(855) 461-3481
Mailing address
8707 COMMERCE DR STE E, EASTON, MD 21601-6910
(443) 239-2033
(855) 461-3481
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
NULL
261QM0850X
Adult Mental Health Clinic/Center
—
NULL
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
NULL
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
07/19/2021
Last updated
01/25/2025
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