Provider Demographics
NPI:1710867510
Name:BRIGHTPATH MENTAL HEALTH SERVICES LLC
Entity type:Organization
Organization Name:BRIGHTPATH MENTAL HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP
Authorized Official - Prefix:
Authorized Official - First Name:SHAKLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAKUR
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:651-246-4705
Mailing Address - Street 1:1350 84TH LN N
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55444-1443
Mailing Address - Country:US
Mailing Address - Phone:651-246-4705
Mailing Address - Fax:612-315-4916
Practice Address - Street 1:1350 84TH LN N
Practice Address - Street 2:
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55444-1443
Practice Address - Country:US
Practice Address - Phone:651-246-4705
Practice Address - Fax:612-315-4916
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-03
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care