Organization
MIND OVER MATTER HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ASIA MARIA JOHNSON MA, LCPC (OWNER)
(410) 982-1353
Entity
Organization
Contact information
Practice address
7700 OLD BRANCH AVE, #B204, CLINTON, MD 20735
(301) 868-0849
(301) 868-2032
Mailing address
2001 FITWARREN PL., T1, BALTO., MD 21209
(410) 982-1353
(443) 766-1713
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
2133
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
401138400
—
MD
Enumeration date
08/08/2013
Last updated
12/20/2016
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