Healthcare Provider Details

I. General information

NPI: 1487592309
Provider Name (Legal Business Name): LOVING MINDS MENTAL HEALING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 E CITY AVE STE 300
BALA CYNWYD PA
19004-1512
US

IV. Provider business mailing address

333 E CITY AVE STE 300 PMB #2068
BALA CYNWYD PA
19004
US

V. Phone/Fax

Practice location:
  • Phone: 267-281-4884
  • Fax: 479-307-4787
Mailing address:
  • Phone: 267-281-4884
  • Fax: 479-307-4787

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: LAVENIA FAIN
Title or Position: PMHNP/FNP
Credential: CRNP
Phone: 215-432-0888