Provider Demographics
NPI:1144014002
Name:WHOLEMIND HEALING PATHWAYS
Entity type:Organization
Organization Name:WHOLEMIND HEALING PATHWAYS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JASMINE
Authorized Official - Middle Name:BYRD MARIE
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:928-550-6705
Mailing Address - Street 1:303 E GURLEY ST # 274
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86301-3804
Mailing Address - Country:US
Mailing Address - Phone:928-550-6705
Mailing Address - Fax:
Practice Address - Street 1:3613 CROSSINGS DR STE B
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86305-7189
Practice Address - Country:US
Practice Address - Phone:928-550-6705
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-07
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty