MEDICARE: FRAME OF MIND 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
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1972238293
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRAME OF MIND LLC

Provider Business Mailing Address
First Line	:	8553 N BEACH ST # 140
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76244-4919
Country	:	US
Telephone Number	:	720-365-3026
Fax Number	:

Provider Business Practice Location Address
First Line	:	4924 CLIBURN DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76244
Country	:	US
Telephone Number	:	720-365-3026
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	UGBODU ENE AWONIYI
Credential	:	NP
Telephone Number	:	720-365-3026

Provider Enumeration Date	:	07/20/2022
Last Update Date	:	07/20/2022

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Directions to “FRAME OF MIND LLC ” Practice Location

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