Healthcare Provider Details

I. General information

NPI: 1942121850
Provider Name (Legal Business Name): SPROUTMIND HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16935 ASHTON OAKS DR
CHARLOTTE NC
28278-8432
US

IV. Provider business mailing address

16935 ASHTON OAKS DR
CHARLOTTE NC
28278-8432
US

V. Phone/Fax

Practice location:
  • Phone: 980-355-9284
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: JUN ZHANG
Title or Position: OWNER
Credential:
Phone: 908-355-9284