Healthcare Provider Details

I. General information

NPI: 1114833993
Provider Name (Legal Business Name): RESTORATION OF THE MIND, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1254 S FARMVIEW DR
DOVER DE
19904-3370
US

IV. Provider business mailing address

1254 S FARMVIEW DR
DOVER DE
19904-3370
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 Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: LASHANDA CRAWFORD
Title or Position: CLINICIAN/OWNER
Credential: LCSW
Phone: 215-687-5151