Provider Demographics
NPI:1275330755
Name:RADIANT MINDS PSYCHIATRY LLC
Entity type:Organization
Organization Name:RADIANT MINDS PSYCHIATRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:PARNELLO
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:702-521-9227
Mailing Address - Street 1:2905 LAKE EAST DR STE 110
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-2384
Mailing Address - Country:US
Mailing Address - Phone:725-577-5055
Mailing Address - Fax:702-405-8700
Practice Address - Street 1:2905 LAKE EAST DR STE 110
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-2384
Practice Address - Country:US
Practice Address - Phone:725-577-5055
Practice Address - Fax:702-405-8700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-03
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty