=====================================================
General NPI Number Information
=====================================================
NPI Number | 1407726052
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MY MIND HEALTH, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/10/2025
-----------------------------------------------------
Last Update Date | 11/10/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8090 NW 12TH ST # 11A
-----------------------------------------------------
City | MARGATE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33063-3081
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-933-3725
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8090 NW 12TH ST # 11A
-----------------------------------------------------
City | MARGATE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33063-3081
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-933-3725
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | JANICE FACEY-BROWN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 954-933-3725
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------