Healthcare Provider Details

I. General information

NPI: 1487310140
Provider Name (Legal Business Name): MINDSTRONG HEALTH SERVICES CO PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2021
Last Update Date: 06/09/2022
Certification Date: 06/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7700 E ARAPAHOE RD STE 220
CENTENNIAL CO
80112-1268
US

IV. Provider business mailing address

303 BRYANT ST
MOUNTAIN VIEW CA
94041-1552
US

V. Phone/Fax

Practice location:
  • Phone: 650-850-7050
  • Fax:
Mailing address:
  • Phone: 650-850-7050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: FRAN MCKOY
Title or Position: CASE MANAGER LLL
Credential: MSW, LCSW
Phone: 256-531-3779