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General NPI Number Information
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NPI Number | 1265151674
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Entity Type | Organization
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Legal Business Name | BEAUTIFUL MINDZ BEHAVIORAL HEALTH AND WELLNESS PLLC
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Dates
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Enumeration Date | 08/26/2022
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Last Update Date | 11/15/2023
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Provider Practice Location Address
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Address Line | 4363 TUCKER CHASE DR
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City | MIDLAND
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State | NC
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Zip | 28107-7812
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Country | US
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Telephone | 704-322-9156
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Fax |
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Provider Business Mailing Address
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Address Line | 4363 TUCKER CHASE DR
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City | MIDLAND
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State | NC
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Zip | 28107-7812
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Country | US
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Telephone | 704-322-9156
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Fax |
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Authorized Official
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Title or Position | PMHNP-BC
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Name | DOROTHY JAMES NIVENS
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Credential | DNP, FNP-C, PMHNP-BC
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Telephone | 704-322-9156
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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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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