MEDICARE: WHOLE MIND PLLC

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	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1922998335
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WHOLE MIND PLLC

Provider Business Mailing Address
First Line	:	1221 S VALLEY GROVE WAY STE 160
Second Line	:
City	:	PLEASANT GROVE
State	:	UT
Zip	:	84062-6758
Country	:	US
Telephone Number	:	801-477-7189
Fax Number	:

Provider Business Practice Location Address
First Line	:	5316 E PICKARD ST
Second Line	:
City	:	MOUNT PLEASANT
State	:	MI
Zip	:	48858-1145
Country	:	US
Telephone Number	:	801-477-7179
Fax Number	:

Authorized Official
Title or Position	:	CHIEF MEDICAL OFFICER
Name	:	THOMAS RAYNER
Credential	:	PSYCHIATRIST
Telephone Number	:	801-815-3106

Provider Enumeration Date	:	07/07/2025
Last Update Date	:	08/26/2025

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Directions to “WHOLE MIND PLLC ” Practice Location

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