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General NPI Number Information
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NPI Number | 1164335626
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Entity Type | Organization
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Legal Business Name | STILLMIND MENTAL HEALTH LLC
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Dates
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Enumeration Date | 09/25/2026
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Last Update Date | 09/25/2026
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Provider Practice Location Address
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Address Line | 2778 CHARLESTOWN RD
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City | NEW ALBANY
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State | IN
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Zip | 47150-1987
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Country | US
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Telephone | 432-599-3383
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Fax |
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Provider Business Mailing Address
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Address Line | 8017 SCHRIEBER RD
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City | FLOYDS KNOBS
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State | IN
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Zip | 47119-9402
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DAMILOLA JAMES ILESANMI
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Credential | PMHNP
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Telephone | 432-599-3383
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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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