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General NPI Number Information
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NPI Number | 1235723321
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Entity Type | Organization
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Legal Business Name | MIND OVER MATTER PSYCHIATRY
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Dates
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Enumeration Date | 03/01/2021
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Last Update Date | 10/08/2025
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Provider Practice Location Address
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Address Line | 607 NORTH AVE OFC 18
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City | WAKEFIELD
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State | MA
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Zip | 01880-1306
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Country | US
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Telephone | 781-705-0567
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Fax | 623-666-6792
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Provider Business Mailing Address
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Address Line | 9793 W SAMPLE RD
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-4003
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Country | US
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Telephone | 781-705-0567
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Fax | 623-666-6792
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Authorized Official
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Title or Position | OWNER
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Name | JESSICA RAMALHO GOULART
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Credential | PMHNP-BC
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Telephone | 781-705-0567
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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