Mind Matters, LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

P0000002807 Issued in TN

Legal business name

MIND MATTERS, LLC

Doing business as

Serenity Center

Practice address

3146 Broad St
Chattanooga, TN 37408-3095

Phone

(423) 800-0483

Fax

(423) 521-8088

NPI assigned

Dec 8, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Susan Elaine Hickman, PH.D., PSY.D.

Title

Owner

Phone

(423) 800-0483

Specialties & licenses 1

Addresses

Other names 1

• Serenity Center Doing business as

Tax ID family

Mind Matters LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Mind Matters, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Chattanooga, TN
  • NPI 1427395029
  NPD tax ID
• Mind Matters, LLC

  • Community/Behavioral Health Agency
  • Chattanooga, TN
  • NPI 1487044251
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1260230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413936000000",
    "number": "1023347838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3146 BROAD ST",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374083095",
            "telephone_number": "423-800-0483",
            "fax_number": "423-521-8088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3146 BROAD ST",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374083095",
            "telephone_number": "423-800-0483",
            "fax_number": "423-521-8088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND MATTERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-08",
        "last_updated": "2014-10-22",
        "status": "A",
        "authorized_official_last_name": "HICKMAN",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "ELAINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "423-800-0483",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D., PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "TN",
            "license": "P0000002807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Serenity Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Wanda Lucinda Millsaps
• Zoa Ann Millsaps
• Andrew Hairston Mims, MD
• Kendra Mina, LCSW
• Bobbie S Mincy, LPN
• Mind Matters, LLC
• Mind Matters, LLC
• Minds of All Kinds
• Natashau McKay Mines, APRN, FNP-C
• Ernest Alexander Minges, D.D.S.

• Clinical Psychologist in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Clinical Psychologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.