Organization
MCS, PC
Active
Other names
Mindoula Health, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
GLENDA WRENN GORDON MD (PRESIDENT)
(888) 879-9786
Entity
Organization
Contact information
Practice address
8040 GEORGIA AVE STE 170, SILVER SPRING, MD 20910-4959
(888) 879-9786
Mailing address
8040 GEORGIA AVE STE 170, SILVER SPRING, MD 20910-4959
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
H877930
OHMCR
OH
Enumeration date
08/30/2019
Last updated
08/22/2024
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