Nourished Minds LLC
Counselor, Mental Health in South Glastonbury, CT. Organization (NPI-2).
NPI number1609613116
StatusActive
Last updated in NPPESJan 3, 2025
Details
- NPI
- 1609613116
- Entity type
- Organization (NPI-2)
- Legal business name
- Nourished Minds LLC
- Organization subpart
- No
- Enumeration date
- Jul 11, 2024
- Certification date
- Jan 3, 2025
- Last updated
- Jan 3, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | – | – | Yes |
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | – | – |
Practice location
891 Main StreetSuite 1b
South Glastonbury, CT 06073
Phone 401-241-1952
Mailing address
56 Petersen RdGranby, CT 06035-1902
Phone 401-241-1952
Authorized official
Miranda Mitchell
Co-Owner
4012411952
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