MEDICARE: MINDFUL MINDS PSYCHIATRY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1396611646
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MINDFUL MINDS PSYCHIATRY

Provider Business Mailing Address
First Line	:	1207 DELAWARE AVE # 1461
Second Line	:
City	:	WILMINGTON
State	:	DE
Zip	:	19806-4743
Country	:	US
Telephone Number	:	302-924-2657
Fax Number	:	302-330-5075

Provider Business Practice Location Address
First Line	:	1207 DELAWARE AVE # 1461
Second Line	:
City	:	WILMINGTON
State	:	DE
Zip	:	19806-4743
Country	:	US
Telephone Number	:	215-209-9491
Fax Number	:	215-209-9491

Authorized Official
Title or Position	:	PMHNP-OWNER
Name	:	KIANA HOLDEN
Credential	:
Telephone Number	:	215-209-9491

Provider Enumeration Date	:	10/14/2025
Last Update Date	:	05/07/2026

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