Mind Care Telepsychiatry

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

MIND CARE TELEPSYCHIATRY

Practice address

21141 Governors Hwy Ste 114
Matteson, IL 60443-3818

Phone

(708) 759-8975

NPI assigned

Jan 10, 2024

Organization subpart

No

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

Authorized official

Name

Venessann Thornton-McLendon

Title

Owner

Phone

(708) 759-8975

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1704844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704844800000",
    "number": "1144091067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21141 GOVERNORS HWY STE 114",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604433818",
            "telephone_number": "708-759-8975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21141 GOVERNORS HWY STE 114",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604433818",
            "telephone_number": "708-759-8975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND CARE TELEPSYCHIATRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-10",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A",
        "authorized_official_last_name": "THORNTON-MCLENDON",
        "authorized_official_first_name": "VENESSANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-759-8975"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Matteson, IL
• Providers in Matteson, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2024; 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.