Healthcare Provider Details

I. General information

NPI: 1417784661
Provider Name (Legal Business Name): MINDCARE SOLUTIONS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2024
Last Update Date: 09/19/2024
Certification Date: 09/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3815 RIVER CORSSING PARKWAY STE 100
INDIANAPOLIS IN
46240
US

IV. Provider business mailing address

4031 ASPEN GROVE DR STE 390
FRANKLIN TN
37067-3118
US

V. Phone/Fax

Practice location:
  • Phone: 330-319-4240
  • Fax:
Mailing address:
  • Phone: 330-319-4240
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: BRIAN NICHOLS
Title or Position: SR VP OF REVENUE OPERATIONS
Credential:
Phone: 330-536-3746