Presence of Mind LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

PRESENCE OF MIND LLC

Practice address

1975 NW 167TH PL Ste 100-20
Beaverton, OR 97006-4908

Phone

(503) 874-6463

Fax

(503) 831-8947

NPI assigned

May 18, 2023

Organization subpart

No

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

Authorized official

Name

Tara Candela, PMHNP-BC

Title

Owner

Phone

(503) 874-6463

Specialties & licenses 1

Addresses

Other names 1

• Presence of Mind, LLC Doing business as

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

{
    "created_epoch": "1684368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696550400000",
    "number": "1124719331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1975 NW 167TH PL",
            "address_2": "STE 100-20",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970064908",
            "telephone_number": "503-874-6463",
            "fax_number": "503-831-8947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1975 NW 167TH PL STE 100-20",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970064908",
            "telephone_number": "503-874-6463",
            "fax_number": "503-831-8947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESENCE OF MIND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-18",
        "last_updated": "2023-10-06",
        "certification_date": "2023-10-06",
        "status": "A",
        "authorized_official_last_name": "CANDELA",
        "authorized_official_first_name": "TARA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-874-6463",
        "authorized_official_credential": "PMHNP-BC"
    },
    "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": [
        {
            "organization_name": "Presence of Mind, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Psychiatric/Mental Health Nurse Practitioner in Beaverton, OR
• Providers in Beaverton, OR by specialty
• Psychiatric/Mental Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2023; 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.