MENDING MINDS LLC NPI 1245833565

NPI Information

NPI: 1245833565
Provider Name: MENDING MINDS, LLC

Doing Business As: WALNUT CREEK PSYCHIATRY

Classification: Nurse Practitioner - 363LP0808X
Entity Type: Organization

Specialization: Psychiatric/Mental Health

Address:
5408 NW 88TH ST STE 140
JOHNSTON, IA
ZIP 50131
Phone: (515) 368-7504
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MENDING MINDS, LLC is a psychiatric/mental health nurse practitioner in Johnston, IA. MENDING MINDS, LLC NPI is 1245833565. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Walnut Creek Psychiatry.

The provider's business location address is:

5408 NW 88TH ST STE 140
JOHNSTON, IA
ZIP 50131-953
Phone: (515) 368-7504
Fax: (515) 355-3491

The provider's authorized official is Hillary Chidester .
The authorized official title is Office Manager and has the following contact phone number (515) 368-7504.

The CLIA number assigned to this NPI record is 16D2287808 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/19/2020 and was last updated on 6/1/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	101YM0800X	Counselor	Mental Health	No
2	1041C0700X	Social Worker	Clinical	No
3	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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