=====================================================
General NPI Number Information
=====================================================
NPI Number | 1225833767
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ARTFUL MIND THERAPY SERVICES PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/18/2025
-----------------------------------------------------
Last Update Date | 02/18/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 27 SOUTHAMPTON PL
-----------------------------------------------------
City | DURHAM
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27705-1857
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 336-558-1537
-----------------------------------------------------
Fax | 984-300-5322
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 27 SOUTHAMPTON PL
-----------------------------------------------------
City | DURHAM
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27705-1857
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 336-558-1537
-----------------------------------------------------
Fax | 984-300-5322
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | SAMANTHA BOYCE
-----------------------------------------------------
Credential | LCMHC
-----------------------------------------------------
Telephone | 919-275-2520
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------