=====================================================
General NPI Number Information
=====================================================
NPI Number | 1477444511
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALTERNATIVE MINDS LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/15/2025
-----------------------------------------------------
Last Update Date | 07/15/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1206 REED CREEK DR
-----------------------------------------------------
City | BASSETT
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 24055-5800
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 276-634-8726
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1206 REED CREEK DR
-----------------------------------------------------
City | BASSETT
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 24055-5800
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 276-252-9921
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/CEO
-----------------------------------------------------
Name | CHELZIE REEVES
-----------------------------------------------------
Credential | LCSW
-----------------------------------------------------
Telephone | 276-634-8726
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------