Provider Demographics
NPI:1902658727
Name:A HEALTHY STATE OF MIND PSYCHIATRY LLC
Entity Type:Organization
Organization Name:A HEALTHY STATE OF MIND PSYCHIATRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:AIMEE
Authorized Official - Middle Name:
Authorized Official - Last Name:BECK
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:978-413-2644
Mailing Address - Street 1:93 OVERLOOK DR
Mailing Address - Street 2:
Mailing Address - City:LEOMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01453-5178
Mailing Address - Country:US
Mailing Address - Phone:978-413-2644
Mailing Address - Fax:
Practice Address - Street 1:47 ASHBY STATE ROAD
Practice Address - Street 2:LOWER LEVEL MEDICAL SUITE
Practice Address - City:FITCHBURG
Practice Address - State:MA
Practice Address - Zip Code:01420
Practice Address - Country:US
Practice Address - Phone:979-378-5779
Practice Address - Fax:978-647-3246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-04
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health