Provider Demographics
NPI:1518670652
Name:MINDME LLC
Entity type:Organization
Organization Name:MINDME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITTINGHILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-571-4102
Mailing Address - Street 1:1523 OAK LACE CT
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32225-2847
Mailing Address - Country:US
Mailing Address - Phone:904-571-4102
Mailing Address - Fax:833-624-1727
Practice Address - Street 1:10163 FORTUNE PKWY
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-3519
Practice Address - Country:US
Practice Address - Phone:904-299-5387
Practice Address - Fax:833-624-1727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-04
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty