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NPI Code Detail

MEDICARE: HEALING MINDS PSYCHIATRY, LLC

MEDICARE: HEALING MINDS PSYCHIATRY, LLC
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
1364SP0808XPsychiatric/Mental Health Clinical Nurse Specialist
2363LP0808XPsychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number : 1477136513
Entity Type Code : Organization
Provider Name (Legal Business Name) : HEALING MINDS PSYCHIATRY, LLC
Provider Business Mailing Address
First Line : 301 STATE AVE
Second Line :
City : TIVERTON
State : RI
Zip : 02878-1062
Country : US
Telephone Number : 774-300-3444
Fax Number : 774-307-9039
Provider Business Practice Location Address
First Line : 301 STATE AVE
Second Line :
City : TIVERTON
State : RI
Zip : 02878-1062
Country : US
Telephone Number : 774-300-3444
Fax Number : 774-307-9039
Authorized Official
Title or Position : PROVIDER
Name : LISA MARIE DEJESUS
Credential : PMHNP
Telephone Number : 774-300-3444
Provider Enumeration Date : 05/05/2021
Last Update Date : 02/07/2024

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Directions to “HEALING MINDS PSYCHIATRY, LLC ” Practice Location

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