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General NPI Number Information
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NPI Number | 1750296976
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Entity Type | Organization
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Legal Business Name | BEAUTIFUL MINDS BEHAVIORAL CONSULTATIONS LLC
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Dates
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Enumeration Date | 08/14/2026
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Last Update Date | 08/14/2026
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Provider Practice Location Address
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Address Line | 2 SOUTHGATE RD APT 38
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City | MIDDLETOWN
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State | NY
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Zip | 10940-2065
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Country | US
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Telephone | 917-569-9407
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Fax |
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Provider Business Mailing Address
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Address Line | 2 SOUTHGATE RD APT 38
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City | MIDDLETOWN
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State | NY
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Zip | 10940-2065
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Country | US
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Telephone | 917-569-9407
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. ADRIENNE WILLIS-CONNPRS
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Credential | MS, CSP
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Telephone | 917-569-9407
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number |
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License Number State |
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