MEDICARE: OPEN MINDS PSYCHIATRIC SERVICES, 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	1041C0700X	Clinical Social Worker
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1396688818
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPEN MINDS PSYCHIATRIC SERVICES, LLC

Provider Business Mailing Address
First Line	:	2040 GAUSE BLVD E
Second Line	:
City	:	SLIDELL
State	:	LA
Zip	:	70461-5453
Country	:	US
Telephone Number	:	601-319-5819
Fax Number	:	601-319-5819

Provider Business Practice Location Address
First Line	:	2040 GAUSE BLVD E
Second Line	:
City	:	SLIDELL
State	:	LA
Zip	:	70461-5453
Country	:	US
Telephone Number	:	601-319-5819
Fax Number	:	601-319-5819

Authorized Official
Title or Position	:	CO-OWNER
Name	:	DONALD ALLEN DEARMAN
Credential	:	NP
Telephone Number	:	601-319-5819

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

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