Organization
MIND-4-CONCEPTS OUTPATIENT MENTAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MICHELLE GILLIAM (OWNER)
(410) 801-8828
Entity
Organization
Contact information
Practice address
1800 N CHARLES ST # 508, BALTIMORE, MD 21201-5920
(410) 801-8828
(443) 817-0863
Mailing address
1800 N CHARLES ST STE 508, BALTIMORE, MD 21201-5920
(410) 801-8828
(443) 817-0863
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
02/24/2025
Last updated
06/05/2025
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