Healthcare Provider Details

I. General information

NPI: 1164335626
Provider Name (Legal Business Name): STILLMIND MENTAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2778 CHARLESTOWN RD
NEW ALBANY IN
47150-1987
US

IV. Provider business mailing address

8017 SCHRIEBER RD
FLOYDS KNOBS IN
47119-9402
US

V. Phone/Fax

Practice location:
  • Phone: 432-599-3383
  • Fax:
Mailing address:
  • Phone: 812-302-2004
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name: DAMILOLA JAMES ILESANMI
Title or Position: MANAGER
Credential: PMHNP
Phone: 812-302-2004