Organization
LIGHT AND MIND WELLNESS LLC
Active
Other names
Light And Mind WELLNESS LLC
Organization subpart
No
Provider details
NPI number
Authorized official
AISHA HASSAN-DAVIS CNS,PMH-NP, APRN (OWNER/PROVIDER)
(443) 239-2033
Entity
Organization
Contact information
Practice address
8707 COMMERCE DR STE E, EASTON, MD 21601-6910
(410) 855-4664
(855) 461-3481
Mailing address
8707 COMMERCE DR STE E, EASTON, MD 21601-6910
(443) 239-2033
(855) 461-3481
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
363L00000X
Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
206453701
—
MD
05
—
250696270
—
DE
Enumeration date
07/19/2021
Last updated
01/25/2025
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