Healthcare Provider Details

I. General information

NPI: 1750976429
Provider Name (Legal Business Name): AP MIND WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2021
Last Update Date: 03/20/2021
Certification Date: 03/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2701 DEL MAR DR
GRAND JUNCTION CO
81506-1723
US

IV. Provider business mailing address

2701 DEL MAR DR
GRAND JUNCTION CO
81506-1723
US

V. Phone/Fax

Practice location:
  • Phone: 970-549-2821
  • Fax:
Mailing address:
  • Phone: 970-549-2821
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: ARIEL K RENDT PADRON
Title or Position: THERAPIST
Credential: LCSW
Phone: 970-549-2821