Healthcare Provider Details

I. General information

NPI: 1831895267
Provider Name (Legal Business Name): HEALTHY MIND PSYCHOTHERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2023
Last Update Date: 09/19/2023
Certification Date: 09/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4790 IRVINE BLVD STE 105-601
IRVINE CA
92620-1973
US

IV. Provider business mailing address

4790 IRVINE BLVD STE 105-601
IRVINE CA
92620-1973
US

V. Phone/Fax

Practice location:
  • Phone: 949-266-4979
  • Fax:
Mailing address:
  • Phone: 949-266-4979
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code102L00000X
TaxonomyPsychoanalyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: MRS. KARUNA SINGH THIND
Title or Position: CEO
Credential: LCSW
Phone: 949-266-4979