Provider Demographics
NPI:1730894189
Name:BEAUTIFUL MIND ARIZONA LLC
Entity type:Organization
Organization Name:BEAUTIFUL MIND ARIZONA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH PROVIDER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BERTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:623-248-1682
Mailing Address - Street 1:4236 N VERRADO WAY STE A-101
Mailing Address - Street 2:
Mailing Address - City:BUCKEYE
Mailing Address - State:AZ
Mailing Address - Zip Code:85396-7594
Mailing Address - Country:US
Mailing Address - Phone:623-248-1682
Mailing Address - Fax:
Practice Address - Street 1:4236 N VERRADO WAY STE A-101
Practice Address - Street 2:
Practice Address - City:BUCKEYE
Practice Address - State:AZ
Practice Address - Zip Code:85396-7594
Practice Address - Country:US
Practice Address - Phone:623-248-1682
Practice Address - Fax:949-561-4677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-19
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty