Healthcare Provider Details

I. General information

NPI: 1639032451
Provider Name (Legal Business Name): BRIGHT MIND BEHAVIORAL HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 N 8TH ST
SMITHFIELD NC
27577-4117
US

IV. Provider business mailing address

460 BATTEN POND RD
SELMA NC
27576-8204
US

V. Phone/Fax

Practice location:
  • Phone: 919-868-9583
  • Fax:
Mailing address:
  • Phone: 919-868-9583
  • 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: TATUM ABBYGALE GODWIN
Title or Position: NONPROFIT OWNER
Credential: N/A
Phone: 919-868-9583