Healthcare Provider Details

I. General information

NPI: 1790418697
Provider Name (Legal Business Name): MIND ALIGN HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2022
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

249 CENTRAL PARK AVE # 300-137
VIRGINIA BEACH VA
23462-3099
US

IV. Provider business mailing address

249 CENTRAL PARK AVE # 300-137
VIRGINIA BEACH VA
23462-3099
US

V. Phone/Fax

Practice location:
  • Phone: 757-785-4449
  • Fax: 757-785-4838
Mailing address:
  • Phone: 757-785-4449
  • Fax: 757-785-4838

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: AYANNA SPENCE
Title or Position: CEO
Credential:
Phone: 757-785-4449