Healthcare Provider Details

I. General information

NPI: 1518802172
Provider Name (Legal Business Name): CONQUER MIND
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2026
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8424 NATIONAL DR
PORT RICHEY FL
34668-3332
US

IV. Provider business mailing address

8424 NATIONAL DR
PORT RICHEY FL
34668-3332
US

V. Phone/Fax

Practice location:
  • Phone: 727-309-2006
  • Fax:
Mailing address:
  • Phone: 727-309-2006
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER EDWARDS
Title or Position: CEO
Credential: LMHC
Phone: 727-309-2006