Healthcare Provider Details

I. General information

NPI: 1922711951
Provider Name (Legal Business Name): HEALTHY MIND PSYCHIATRIC CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2023
Last Update Date: 03/23/2023
Certification Date: 03/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 FERRY ST STE 307
CONCORD NH
03301-5081
US

IV. Provider business mailing address

10 FERRY ST STE 307
CONCORD NH
03301-5081
US

V. Phone/Fax

Practice location:
  • Phone: 613-219-2383
  • Fax:
Mailing address:
  • Phone: 613-219-2383
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: COLLEEN ESTES
Title or Position: PMHNP-BC, FNP-C
Credential: MSN, APRN
Phone: 603-219-2383