Healthcare Provider Details

I. General information

NPI: 1699543785
Provider Name (Legal Business Name): MINDSET PSYCHIATRIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2023
Last Update Date: 12/18/2023
Certification Date: 12/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7222 COMMERCE CENTER DR STE 220
COLORADO SPRINGS CO
80919-2631
US

IV. Provider business mailing address

1086 BECKTON HTS APT 305
COLORADO SPRINGS CO
80907-6580
US

V. Phone/Fax

Practice location:
  • Phone: 145-852-0902
  • Fax:
Mailing address:
  • Phone: 214-585-2090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ERIN M BAYLES
Title or Position: CREDENTIALING
Credential:
Phone: 478-290-3122