Provider Demographics
NPI:1306640784
Name:EPIC MINDS THERAPY MD LLC
Entity type:Organization
Organization Name:EPIC MINDS THERAPY MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:FRIED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:848-226-0466
Mailing Address - Street 1:6865 DEERPATH RD STE 101
Mailing Address - Street 2:
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-6255
Mailing Address - Country:US
Mailing Address - Phone:855-995-3742
Mailing Address - Fax:743-219-2148
Practice Address - Street 1:6865 DEERPATH RD STE 101
Practice Address - Street 2:
Practice Address - City:ELKRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21075-6255
Practice Address - Country:US
Practice Address - Phone:855-995-3742
Practice Address - Fax:743-219-2148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-03
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty