Healthcare Provider Details

I. General information

NPI: 1053838680
Provider Name (Legal Business Name): SIMPLY SOUND MIND, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 WASHINGTON ST STE 208
MONROE LA
71201-6762
US

IV. Provider business mailing address

300 WASHINGTON ST STE 208
MONROE LA
71201-6762
US

V. Phone/Fax

Practice location:
  • Phone: 318-651-8337
  • Fax:
Mailing address:
  • Phone: 318-651-8337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP07290
License Number StateLA

VIII. Authorized Official

Name: LOURDES PINEDA TORRES
Title or Position: MANAGER
Credential: APRN
Phone: 318-651-8337