| Mindbodypinnacle Health Llc | |
|
9811 Mallard Dr Ste 210 Laurel MD 20708-3199 | |
| (443) 713-8643 | |
| Not Available |
| Full Name | Mindbodypinnacle Health Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 9811 Mallard Dr Ste 210, Laurel, Maryland |
| Authorized Official Name and Position | Taiwo Ajani (CRNP) |
| Authorized Official Contact | 3012372563 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindbodypinnacle Health Llc 9811 Mallard Dr Ste 210 Laurel MD 20708-3199 Ph: (443) 713-8643 | Mindbodypinnacle Health Llc 9811 Mallard Dr Ste 210 Laurel MD 20708-3199 Ph: (443) 713-8643 |
| NPI Number | 1275263816 |
|---|---|
| Provider Enumeration Date | 06/15/2022 |
| Last Update Date | 05/09/2025 |
| Certification Date | 05/09/2025 |
| Medicare PECOS PAC ID | 5395100507 |
|---|---|
| Medicare Enrollment ID | O20230421002625 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275263816 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Taiwo Ajani |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982170213 PECOS PAC ID: 5092047357 Enrollment ID: I20191106000992 |
| Provider Name | Animbeng Asongwe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609139096 PECOS PAC ID: 6406385178 Enrollment ID: I20250124001334 |
| Provider Name | Vanessa Ange Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659100949 PECOS PAC ID: 8123556172 Enrollment ID: I20250131000462 |
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