Healthcare Provider Details

I. General information

NPI: 1477491744
Provider Name (Legal Business Name): ANJEL OF MIND LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2026
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47523 CATHY LN
ROBERT LA
70455-4703
US

IV. Provider business mailing address

47523 CATHY LN
ROBERT LA
70455-4703
US

V. Phone/Fax

Practice location:
  • Phone: 985-200-0597
  • Fax:
Mailing address:
  • Phone: 985-200-0597
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MS. RAVEN ANJEL WINDING
Title or Position: OWNER, SOLE MEMBER
Credential: MSW, LCSW
Phone: 985-200-0597