Organization Active NPI

Macnificent Minds

  • Psychiatric/Mental Health Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1073497574
Registry record updated Oct 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
MACNIFICENT MINDS
Practice address
4333 Village Trace CT
Indianapolis, IN 46254-6232
Phone
(463) 222-9605
Fax
(317) 342-8372
NPI assigned
Aug 5, 2025
Last updated
Oct 8, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2026

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

Authorized official

Name
Ashlee Mack, NPNPI 1942811682
Title
Owner
Phone
(463) 222-9605

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X NU
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU Primary

Addresses

Primary practice location

4333 Village Trace CT
Indianapolis, IN 46254-6232

Mailing address

3410 N High School Rd Ste G
Indianapolis, IN 46224-1100
Phone (463) 222-9605

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": "1754352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791417600000",
    "number": "1073497574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3410 N HIGH SCHOOL RD STE G",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462241100",
            "telephone_number": "463-222-9605",
            "fax_number": "317-342-8372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4333 VILLAGE TRACE CT",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462546232",
            "telephone_number": "463-222-9605",
            "fax_number": "317-342-8372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MACNIFICENT MINDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-05",
        "last_updated": "2026-10-08",
        "certification_date": "2026-10-08",
        "status": "A",
        "authorized_official_last_name": "MACK",
        "authorized_official_first_name": "ASHLEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "463-222-9605",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 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.