Provider Demographics
NPI:1902581564
Name:A MIND RENEWED
Entity Type:Organization
Organization Name:A MIND RENEWED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LASHONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:513-327-5225
Mailing Address - Street 1:1172 W GALBRAITH RD STE 205B
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45231-5644
Mailing Address - Country:US
Mailing Address - Phone:513-327-5225
Mailing Address - Fax:513-586-4882
Practice Address - Street 1:1172 W GALBRAITH RD STE 205B
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45231-5644
Practice Address - Country:US
Practice Address - Phone:513-327-5225
Practice Address - Fax:513-586-4882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-20
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty