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General NPI Number Information
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NPI Number | 1205603651
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Entity Type | Organization
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Legal Business Name | HEALING MINDS WELLNESS LLC MENTAL HEALTH CLINIC
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Dates
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Enumeration Date | 12/06/2023
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Last Update Date | 12/06/2023
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Provider Practice Location Address
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Address Line | 16616 BILTMORE AVE
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City | CLEVELAND
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State | OH
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Zip | 44128-1442
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Country | US
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Telephone | 216-798-7433
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Fax |
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Provider Business Mailing Address
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Address Line | 16616 BILTMORE AVE
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City | CLEVELAND
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State | OH
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Zip | 44128-1442
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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 | CREDENTIALING SPECIALIST
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Name | LISA SULLIVAN
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Credential |
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Telephone | 440-453-0754
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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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