Organization
NIMEL TMS & SPRAVATO CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOSUNMOLA SANDRA LAKE (MEDICAL DIRECTOR)
(301) 272-1558
Entity
Organization
Contact information
Practice address
6215 GREENBELT RD STE 107, BERWYN HEIGHTS, MD 20740-2355
(301) 272-1558
(301) 272-1559
Mailing address
10801 GREEN ASH LN, BELTSVILLE, MD 20705-3851
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
10/06/2025
Last updated
10/06/2025
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