# MIND RENEWED PSYCHIATRY LLC

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

## Provider details

- **NPI number:** 1659115996
- **Authorized official:** DAGUSE DONACIN NP (NURSE PRACTITONER)
- **Authorized official phone:** (202) 800-8919

## Contact information

- **Practice address:** 9015 WOODYARD RD STE 202, CLINTON, MD 20735-4209
- **Practice address phone:** (202) 800-8919
- **Practice address fax:** (771) 717-8669
- **Mailing address:** 712 H ST NE STE 8919, WASHINGTON, DC 20002-3627
- **Mailing address phone:** (202) 800-8919
- **Mailing address fax:** (771) 717-8669

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 06/21/2024
- **Last updated:** 12/10/2025