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General NPI Number Information
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NPI Number | 1104622893
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Entity Type | Organization
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Legal Business Name | BEAUTIFUL MINDS PSYCHIATRY
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Dates
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Enumeration Date | 02/22/2025
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Last Update Date | 05/28/2025
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Provider Practice Location Address
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Address Line | 16421 S 88TH AVE
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City | ORLAND PARK
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State | IL
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Zip | 60462
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Country | US
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Telephone | 708-232-8854
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Fax | 877-221-8040
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Provider Business Mailing Address
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Address Line | 15826 S LA GRANGE RD # 227
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City | ORLAND PARK
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State | IL
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Zip | 60462-7793
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Country | US
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Telephone | 708-504-6242
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Fax | 877-221-8040
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Authorized Official
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Title or Position | NURSE PRACTITIONER / OWNER
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Name | BRANDY MCCRUDDEN
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Credential | DNP
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Telephone | 708-232-8854
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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