Provider Demographics
NPI:1932089463
Name:PRIME MINDS THERAPY AND BEYOND, LLC
Entity type:Organization
Organization Name:PRIME MINDS THERAPY AND BEYOND, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LARANDA
Authorized Official - Middle Name:BUTLER
Authorized Official - Last Name:JASON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:318-245-9034
Mailing Address - Street 1:2410 WAYNE ST
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:LA
Mailing Address - Zip Code:71251-9307
Mailing Address - Country:US
Mailing Address - Phone:318-202-9824
Mailing Address - Fax:
Practice Address - Street 1:2905 CAMERON ST STE B1032
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-3790
Practice Address - Country:US
Practice Address - Phone:318-202-9824
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-04
Last Update Date:2025-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty