1477245223 NPI number — BETTER MIND BEHAVIORAL HEALTH PLLC

Table of content: (NPI 1477245223)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477245223 NPI number — BETTER MIND BEHAVIORAL HEALTH PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BETTER MIND BEHAVIORAL HEALTH PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1477245223
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/22/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1629 K ST NW STE 300
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WASHINGTON
Provider Business Mailing Address State Name:
DC
Provider Business Mailing Address Postal Code:
20006-1631
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
202-600-7777
Provider Business Mailing Address Fax Number:
202-459-8998

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1629 K ST NW STE 300
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20006-1631
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-600-7777
Provider Business Practice Location Address Fax Number:
202-459-8998
Provider Enumeration Date:
05/22/2023

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MOORER
Authorized Official First Name:
DIANA
Authorized Official Middle Name:
Authorized Official Title or Position:
DNP
Authorized Official Telephone Number:
813-833-7474

Provider Taxonomy Codes

  • Taxonomy code: 261QM0850X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM0855X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP0808X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)