MEDICARE: CHANGING MINDS PSYCHIATRY LA 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
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1396681516
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHANGING MINDS PSYCHIATRY LA LLC

Provider Business Mailing Address
First Line	:	PO BOX 752003
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89136-2003
Country	:	US
Telephone Number	:	702-405-8088
Fax Number	:	702-405-6066

Provider Business Practice Location Address
First Line	:	13360 COURSEY BLVD STE B
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70816-5025
Country	:	US
Telephone Number	:	702-405-8088
Fax Number	:	702-405-8088

Authorized Official
Title or Position	:	BUSINESS MANAGER
Name	:	JAMIE BROWN
Credential	:
Telephone Number	:	702-405-8088

Provider Enumeration Date	:	04/28/2026
Last Update Date	:	06/10/2026

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