Healthcare Provider Details

I. General information

NPI: 1679460729
Provider Name (Legal Business Name): NEW DAY PSYCHIATRIC CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2025
Last Update Date: 06/24/2025
Certification Date: 06/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5910 77TH ST STE A
KENOSHA WI
53142-4104
US

IV. Provider business mailing address

5910 77TH ST STE A
KENOSHA WI
53142-4104
US

V. Phone/Fax

Practice location:
  • Phone: 262-818-6615
  • Fax:
Mailing address:
  • Phone: 262-818-6615
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SCOTT D MINGILINO
Title or Position: OWNER / NURSE PRACTITIONER
Credential: PMHNP-BC, FNP-BC
Phone: 262-818-6615