Healthcare Provider Details

I. General information

NPI: 1972911121
Provider Name (Legal Business Name): PREMIER MINDS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2014
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2609 SCRIPTURE ST
DENTON TX
76201-2302
US

IV. Provider business mailing address

2609 SCRIPTURE ST
DENTON TX
76201-2302
US

V. Phone/Fax

Practice location:
  • Phone: 940-442-5209
  • Fax:
Mailing address:
  • Phone: 940-442-5209
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateTX

VIII. Authorized Official

Name: CAROL NGUYEN
Title or Position: DIRECTOR
Credential:
Phone: 940-442-5209