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General NPI Number Information
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NPI Number | 1396548921
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Entity Type | Organization
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Legal Business Name | SUBLIME MIND, PLLC
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Dates
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Enumeration Date | 03/29/2025
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 911 FIRST COLONIAL RD STE 100
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City | VIRGINIA BEACH
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State | VA
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Zip | 23454-3111
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Country | US
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Telephone | 757-280-4801
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Fax | 757-767-7866
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Provider Business Mailing Address
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Address Line | 104 MARINERS CT
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City | SMITHFIELD
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State | VA
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Zip | 23430-5630
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Country | US
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Telephone | 757-280-4801
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Fax | 757-767-7866
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Authorized Official
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Title or Position | BILLER
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Name | KIMM HALL
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Credential |
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Telephone | 813-395-9269
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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