Healthcare Provider Details

I. General information

NPI: 1336053297
Provider Name (Legal Business Name): RESTORATION OF THE MIND, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 THE GRN STE 18788
DOVER DE
19901-3618
US

IV. Provider business mailing address

8 THE GRN STE 18788
DOVER DE
19901-3618
US

V. Phone/Fax

Practice location:
  • Phone: 302-219-0973
  • Fax:
Mailing address:
  • Phone: 302-219-0973
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name: LASHANDA C CRAWFORD
Title or Position: CLINICAL SOCIAL WORKER
Credential: LCSW
Phone: 215-687-5151