Organization
N.E. BEAUTIFUL MIND, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JERNAE DICKENS LPC, NCC (OWNER/CLINICAL THERAPIST)
(301) 640-0300
Entity
Organization
Contact information
Practice address
1050 30TH ST NW # 107, WASHINGTON, DC 20007-3822
(301) 640-0300
Mailing address
3210 WINTERBOURNE DR, UPPER MARLBORO, MD 20774-9084
(202) 246-8323
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BCBS2022
BLUECROSS & BLUE SHEILD
—
05
—
DC2022
—
DC
01
—
UHC2022
UNITED HEALTHCARE
—
Enumeration date
08/29/2022
Last updated
11/09/2022
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