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1679433205 NPI number — MIND THERAPY LLC

NPI Number: 1679433205
Health Care Provider/Practitioner: MIND THERAPY LLC

Information about “1679433205” NPI (MIND THERAPY LLC) exists in 1679433205 in HTML format HTML  |  1679433205 in plain Text format TXT  |  1679433205 in PDF (Portable Document Format) PDF  |  1679433205 in an XML format XML  formats.

NPI Number : 1679433205 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1679433205",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "MIND THERAPY LLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "500 MARQUETTE AVE NW STE 1200",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ALBUQUERQUE",
    "MailingAddressStateName": "NM",
    "MailingAddressPostalCode": "87102-5312",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "505-503-4803",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "500 MARQUETTE AVE NW STE 1200",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "ALBUQUERQUE",
    "PracticeLocationAddressStateName": "NM",
    "PracticeLocationAddressPostalCode": "87102-5312",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "505-503-4803",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "11/15/2025",
    "LastUpdateDate": "11/15/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "HASSAN",
    "AuthorizedOfficialFirstName": "AYAN",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "MANAGER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "505-503-4803",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "252Y00000X",
        "TaxonomyName": "Early Intervention Provider Agency",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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