Provider Demographics
NPI:1629891080
Name:REDESIGNING MINDS, LLC
Entity type:Organization
Organization Name:REDESIGNING MINDS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PMHNP-BC
Authorized Official - Prefix:MS
Authorized Official - First Name:KIMBERLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:PITTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:504-909-4569
Mailing Address - Street 1:1901 MANHATTAN BLVD
Mailing Address - Street 2:BLDG D SUITE 108
Mailing Address - City:HARVEY
Mailing Address - State:LA
Mailing Address - Zip Code:70058
Mailing Address - Country:US
Mailing Address - Phone:504-909-4569
Mailing Address - Fax:
Practice Address - Street 1:1901 MANHATTAN BLVD
Practice Address - Street 2:BLDG D SUITE 108
Practice Address - City:HARVEY
Practice Address - State:LA
Practice Address - Zip Code:70058
Practice Address - Country:US
Practice Address - Phone:504-909-4569
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-04
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health