Healthcare Provider Details
I. General information
NPI: 1396442539
Provider Name (Legal Business Name): MIND AND BODY HEALTHCARE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/08/2023
Last Update Date: 02/08/2023
Certification Date: 02/08/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5460 WARD RD STE 305
ARVADA CO
80002-1800
US
IV. Provider business mailing address
12650 W 64TH AVE UNIT E
ARVADA CO
80004-3887
US
V. Phone/Fax
- Phone: 720-853-1300
- Fax: 720-853-1305
- Phone: 720-853-1300
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0801X |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
REBEKAH
TURNER
Title or Position: OWNER
Credential: FNP, PMHNP
Phone: 720-383-1893