Organization Active NPI

Change of Mind LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Mesa, AZ
National Provider Identifier
1053264788
Registry record updated Feb 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
CHANGE OF MIND LLC
Practice address
11331 E Starfire Cir
Mesa, AZ 85212-7062
Phone
(148) 068-6017
NPI assigned
Feb 20, 2026
Last updated
Feb 20, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2026

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

Authorized official

Name
Ms. Susan Ann Willever, PMHNPNPI 1134527534
Title
Managing Member
Phone
(480) 686-0170

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

11331 E Starfire Cir
Mesa, AZ 85212-7062

Mailing address

11331 E Starfire Cir
Mesa, AZ 85212-7062
Phone (148) 068-6017

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1771545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771545600000",
    "number": "1053264788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11331 E STARFIRE CIR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852127062",
            "telephone_number": "148-068-6017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11331 E STARFIRE CIR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852127062",
            "telephone_number": "148-068-6017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANGE OF MIND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-02-20",
        "last_updated": "2026-02-20",
        "certification_date": "2026-02-20",
        "status": "A",
        "authorized_official_last_name": "WILLEVER",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "480-686-0170",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2026; 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.