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NPI Code Detail

MEDICARE: A BEAUTIFUL MIND LLC

MEDICARE: A BEAUTIFUL MIND LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorCP0242NV

General Provider Information

NPI Number : 1275010944
Entity Type Code : Organization
Provider Name (Legal Business Name) : A BEAUTIFUL MIND LLC
Provider Business Mailing Address
First Line : 9205 W RUSSELL RD STE 240
Second Line :
City : LAS VEGAS
State : NV
Zip : 89148-1425
Country : US
Telephone Number : 702-793-4493
Fax Number : 702-793-4493
Provider Business Practice Location Address
First Line : 9205 W RUSSELL RD STE 240
Second Line :
City : LAS VEGAS
State : NV
Zip : 89148-1425
Country : US
Telephone Number : 702-793-4493
Fax Number : 702-793-4493
Authorized Official
Title or Position : OWNER
Name : PATRICK TIMOTHY CUMMINGS
Credential :
Telephone Number : 702-793-4493
Provider Enumeration Date : 07/25/2018
Last Update Date : 07/25/2018

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Directions to “A BEAUTIFUL MIND LLC ” Practice Location

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