Provider Demographics
NPI:1861917056
Name:MOUNTAIN MIND, LLC
Entity type:Organization
Organization Name:MOUNTAIN MIND, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:A
Authorized Official - Last Name:YORK
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, PMHNP-BC, APRN
Authorized Official - Phone:720-788-6068
Mailing Address - Street 1:1863 WAZEE ST APT 1G
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80202-1248
Mailing Address - Country:US
Mailing Address - Phone:720-788-6068
Mailing Address - Fax:719-207-4464
Practice Address - Street 1:1863 WAZEE ST APT 1G
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80202-1248
Practice Address - Country:US
Practice Address - Phone:303-808-8816
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-08
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0993185363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty