Healthcare Provider Details

I. General information

NPI: 1194656660
Provider Name (Legal Business Name): TRUE NORTH BODY & MIND LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46 BELMONT ST
WAYMART PA
18472-9210
US

IV. Provider business mailing address

46 BELMONT ST
WAYMART PA
18472-9210
US

V. Phone/Fax

Practice location:
  • Phone: 570-780-4034
  • Fax:
Mailing address:
  • Phone: 570-780-4034
  • 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: KRISTEN FAHEY
Title or Position: PMHNP-BC
Credential: CRNP
Phone: 570-780-4034