Healthcare Provider Details

I. General information

NPI: 1558210732
Provider Name (Legal Business Name): HEALTHY MINDS SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 BW THOMAS DR STE 122
FORT MILL SC
29708-7244
US

IV. Provider business mailing address

150 BW THOMAS DR STE 122
FORT MILL SC
29708-7244
US

V. Phone/Fax

Practice location:
  • Phone: 704-833-8355
  • Fax: 704-943-5177
Mailing address:
  • Phone: 704-833-8355
  • Fax: 704-943-5177

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: AHMAD BLAKENEY
Title or Position: CEO/DIRECTOR
Credential: BLAKENEY
Phone: 704-833-8355