Ageless Minds LLC

Primary specialty

Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0808X

Legal business name

AGELESS MINDS LLC

Practice address

9165 Otis Ave Ste 164
Indianapolis, IN 46216-2312

Phone

(317) 930-1557

NPI assigned

Apr 10, 2026

Organization subpart

No

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

Authorized official

Name

Queela Tadoum, NPNPI 1598427809

Title

Owner

Phone

(317) 930-1557

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Queela Tadoum, NP

  • Psychiatric/Mental Health Clinical Nurse Specialist
  • Indianapolis, IN
  • NPI 1598427809

  Psychiatric/Mental Health

  NPD Authorized official

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

{
    "created_epoch": "1775779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775779200000",
    "number": "1104769611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9165 OTIS AVE STE 164",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462162312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9165 OTIS AVE STE 164",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462162312",
            "telephone_number": "317-930-1557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGELESS MINDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-10",
        "last_updated": "2026-04-10",
        "certification_date": "2026-04-10",
        "status": "A",
        "authorized_official_last_name": "TADOUM",
        "authorized_official_first_name": "QUEELA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-930-1557",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "364SP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ageless Center LLC
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• Psychiatric/Mental Health Clinical Nurse Specialist in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Psychiatric/Mental Health Clinical Nurse Specialist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 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.