Healthcare Provider Details

I. General information

NPI: 1619505104
Provider Name (Legal Business Name): HEALING MINDS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2020
Last Update Date: 03/30/2020
Certification Date: 03/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1099 GENERAL KNOX RD STE 2
WASHINGTON CROSSING PA
18977-1369
US

IV. Provider business mailing address

PO BOX 32
NEWTOWN PA
18940-0032
US

V. Phone/Fax

Practice location:
  • Phone: 215-385-3078
  • Fax:
Mailing address:
  • Phone: 215-385-3078
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: PETER MORRIS
Title or Position: OWNER
Credential: NP
Phone: 215-385-3078