MEDICARE: MIND-TOUCH PSYCHIATRY & INTEGRATIVE CARE, 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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1548961550
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIND-TOUCH PSYCHIATRY & INTEGRATIVE CARE, LLC

Provider Business Mailing Address
First Line	:	5900 BALCONES DR
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78731-4257
Country	:	US
Telephone Number	:	405-922-5280
Fax Number	:

Provider Business Practice Location Address
First Line	:	2384 HIGHWAY 287 N STE 218
Second Line	:
City	:	MANSFIELD
State	:	TX
Zip	:	76063-9207
Country	:	US
Telephone Number	:	682-253-2130
Fax Number	:

Authorized Official
Title or Position	:	CREDENTIAL COORD
Name	:	TRALICA CLEWIS
Credential	:	CMA
Telephone Number	:	469-586-7643

Provider Enumeration Date	:	03/15/2023
Last Update Date	:	12/05/2025

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