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General NPI Number Information
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NPI Number | 1164320776
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Entity Type | Organization
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Legal Business Name | SERENITY MIND COLLABORATIVE
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Dates
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Enumeration Date | 10/26/2026
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Last Update Date | 10/26/2026
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Provider Practice Location Address
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Address Line | 1022 23RD AVE
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City | BELLWOOD
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State | IL
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Zip | 60104-2509
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Country | US
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Telephone | 312-685-1163
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Fax | 734-715-2358
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Provider Business Mailing Address
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Address Line | 980 N MICHIGAN AVE
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City | CHICAGO
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State | IL
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Zip | 60611-4501
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Country | US
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Telephone | 312-685-1163
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Fax | 734-715-2358
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Authorized Official
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Title or Position | OWNER
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Name | MS. WYTONYA BYRD
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Credential | MSN,APRN, PMHNP-BC
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Telephone | 312-685-1163
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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