Healthcare Provider Details

I. General information

NPI: 1124548581
Provider Name (Legal Business Name): HEALTHYMINDS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2017
Last Update Date: 02/19/2025
Certification Date: 02/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 BOULEVARD SUITE F
COLONIAL HEIGHTS VA
23834
US

IV. Provider business mailing address

2801 BOULEVARD STE F
COLONIAL HEIGHTS VA
23834-2323
US

V. Phone/Fax

Practice location:
  • Phone: 804-479-3515
  • Fax: 804-898-3999
Mailing address:
  • Phone: 804-479-3515
  • Fax: 804-898-3999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2710
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. SHERIKA MONIQUE ALLEN
Title or Position: OWNER
Credential:
Phone: 804-479-3515