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General NPI Number Information
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NPI Number | 1588547418
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Entity Type | Organization
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Legal Business Name | MIND JOY PSYCHIATRY LLC
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Dates
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Enumeration Date | 07/29/2025
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Last Update Date | 07/29/2025
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Provider Practice Location Address
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Address Line | 1729 NW SAINT LUCIE WEST BLVD # 1268
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City | PORT ST LUCIE
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State | FL
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Zip | 34986-2501
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Country | US
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Telephone | 386-264-4899
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Fax | 833-463-2196
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Provider Business Mailing Address
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Address Line | 1729 NW SAINT LUCIE WEST BLVD # 1268
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City | PORT ST LUCIE
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State | FL
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Zip | 34986-2501
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Country | US
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Telephone | 386-264-4899
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Fax | 833-463-2196
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Authorized Official
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Title or Position | MANAGER
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Name | AL BERRY
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Credential |
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Telephone | 469-915-4211
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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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