Healthcare Provider Details

I. General information

NPI: 1972284719
Provider Name (Legal Business Name): HEALTHY MINDS FOR YOU LPA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2023
Last Update Date: 07/25/2023
Certification Date: 07/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11492 YOUNGSTOWN PITTSBURGH RD
NEW MIDDLETOWN OH
44442-8706
US

IV. Provider business mailing address

6578 N CAROLINA PL
POLAND OH
44514-4221
US

V. Phone/Fax

Practice location:
  • Phone: 330-915-2773
  • Fax: 330-662-6117
Mailing address:
  • Phone: 330-881-6080
  • Fax: 330-662-6117

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: MISS ASHLEIGH REBECCA NOEL
Title or Position: PSYCHIATRIC NP AND OWNER
Credential: NP
Phone: 330-881-6080