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General NPI Number Information
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NPI Number | 1326972118
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Entity Type | Organization
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Legal Business Name | NEURODIVERGENT MINDS, LLC
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Dates
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Enumeration Date | 06/09/2026
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Last Update Date | 06/09/2026
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Provider Practice Location Address
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Address Line | 217 HOPWOOD COOLSPRING RD
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City | HOPWOOD
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State | PA
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Zip | 15445-2226
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Country | US
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Telephone | 724-320-9524
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Fax | 724-862-1075
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Provider Business Mailing Address
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Address Line | 217 HOPWOOD COOLSPRING RD
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City | HOPWOOD
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State | PA
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Zip | 15445-2226
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Country | US
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Telephone | 724-320-9524
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Fax | 724-862-1075
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Authorized Official
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Title or Position | OWNER/CEO
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Name | MRS. CHASIDY J ELLSWORTH
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Credential | MS, NCC, LPC,CCTP-II
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Telephone | 724-320-9524
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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