| Beautiful Mindz Behavioral Health And Wellness Pllc | |
|
4363 Tucker Chase Dr Midland NC 28107-7812 | |
| (704) 322-9156 | |
| Not Available |
| Full Name | Beautiful Mindz Behavioral Health And Wellness Pllc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 4363 Tucker Chase Dr, Midland, North Carolina |
| Authorized Official Name and Position | Dorothy James Nivens (PMHNP-BC) |
| Authorized Official Contact | 7043229156 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Beautiful Mindz Behavioral Health And Wellness Pllc 4363 Tucker Chase Dr Midland NC 28107-7812 Ph: (704) 322-9156 | Beautiful Mindz Behavioral Health And Wellness Pllc 4363 Tucker Chase Dr Midland NC 28107-7812 Ph: (704) 322-9156 |
| NPI Number | 1265151674 |
|---|---|
| Provider Enumeration Date | 08/26/2022 |
| Last Update Date | 11/15/2023 |
| Certification Date | 11/15/2023 |
| Medicare PECOS PAC ID | 8527435510 |
|---|---|
| Medicare Enrollment ID | O20221103002596 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265151674 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Primary |
| Provider Name | Dorothy Nivens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003261074 PECOS PAC ID: 8820381890 Enrollment ID: I20161108000804 |
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