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General NPI Number Information
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NPI Number | 1306713243
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Entity Type | Organization
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Legal Business Name | INCLUSIVE MINDS FOUNDATION CO.
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Dates
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Enumeration Date | 10/23/2025
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Last Update Date | 02/10/2026
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Provider Practice Location Address
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Address Line | 254 COMMERCIAL ST STE 245B
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City | PORTLAND
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State | ME
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Zip | 04101-4664
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Country | US
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Telephone | 929-564-3880
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Fax |
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Provider Business Mailing Address
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Address Line | 167 MADISON AVE STE 205 #4667
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City | NEW YORK
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State | NY
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Zip | 10016
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Country | US
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Telephone | 929-223-6825
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | RAHIMEH ANDALIBIAN
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Credential | PSY.D.
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Telephone | 929-564-3880
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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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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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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