Organization Active NPI

Mindhealth Behavioral PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1154035012
Registry record updated Mar 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
MINDHEALTH BEHAVIORAL PLLC
Practice address
311 W 24TH St
Charlotte, NC 28206-2608
Phone
(704) 264-6208
NPI assigned
Jan 5, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2023

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

Authorized official

Name
Ngozi Nnaji, DNPNPI 1346461431
Title
Nurse Practitioner
Phone
(704) 264-6208

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
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

311 W 24TH St
Charlotte, NC 28206-2608

Mailing address

311 W 24TH St
Charlotte, NC 28206-2608
Phone (704) 264-6208

Other names 1

  • MINDHEALTH BEHAVIORAL PLLC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230504001065 NC Part B Supplier - Clinic/Group Practice 2860857463 Receives reassigned benefits from 1 practitioner
Practice locations: Charlotte, NC

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.

NPI Registry JSON

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

{
    "created_epoch": "1672876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678320000000",
    "number": "1154035012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 W 24TH ST",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282062608",
            "telephone_number": "704-264-6208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 W 24TH ST",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282062608",
            "telephone_number": "704-264-6208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDHEALTH BEHAVIORAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-05",
        "last_updated": "2023-03-09",
        "certification_date": "2023-03-09",
        "status": "A",
        "authorized_official_last_name": "NNAJI",
        "authorized_official_first_name": "NGOZI",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "704-264-6208",
        "authorized_official_credential": "DNP"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MINDHEALTH BEHAVIORAL PLLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MINDHEALTH BEHAVIORAL PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.