Healthcare Provider Details

I. General information

NPI: 1033029855
Provider Name (Legal Business Name): VITALMIND MENTAL HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

451 ANDOVER ST STE 130
NORTH ANDOVER MA
01845-5070
US

IV. Provider business mailing address

451 ANDOVER ST STE 130
NORTH ANDOVER MA
01845-5070
US

V. Phone/Fax

Practice location:
  • Phone: 978-808-0615
  • Fax: 228-220-7697
Mailing address:
  • Phone: 978-808-0615
  • Fax: 228-220-7697

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: PETER N KAMANDE
Title or Position: MANAGING MEMBER
Credential: PMHNP-BC
Phone: 978-808-0615