Active NPI
State of Mind
- Psychiatric/Mental Health Nurse Practitioner
- Yakima, WA
National Provider Identifier
1154160604
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- Legal business name
- STATE OF MIND
- Practice address
- 411 S 12TH Ave Ste 2
Yakima, WA 98902-3109 - Phone
- (509) 969-3908
- Fax
- (509) 873-7188
- NPI assigned
- May 23, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- James Kendall Eakin, DNP, ARNP, PMHNP-BC
- Title
- Owner/Practitioner
- Phone
- (509) 969-3908
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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | Primary |
Addresses
Primary practice location
411 S 12TH Ave Ste 2
Yakima, WA 98902-3109
Mailing address
11202 Cottonwood Canyon Rd
Yakima, WA 98908-9372
Phone (509) 969-3908
Other names 1
- State of Mind
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
1460 N 16th Ave
Ste A
Yakima, WA 98902
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Psychiatric/Mental Health Nurse Practitioner
- Yakima, WA
- NPI 1023688769
-
- Social Worker
- Yakima, WA
- NPI 1306458849
-
- Psychiatric/Mental Health Nurse Practitioner
- Toppenish, WA
- NPI 1396031266
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1716422400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1716422400000",
"number": "1154160604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11202 COTTONWOOD CANYON RD",
"city": "YAKIMA",
"state": "WA",
"postal_code": "989089372",
"telephone_number": "509-969-3908",
"fax_number": "509-873-7188"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "411 S 12TH AVE STE 2",
"city": "YAKIMA",
"state": "WA",
"postal_code": "989023109",
"telephone_number": "509-969-3908",
"fax_number": "509-873-7188"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "STATE OF MIND",
"organizational_subpart": "NO",
"enumeration_date": "2024-05-23",
"last_updated": "2024-05-23",
"certification_date": "2024-05-23",
"status": "A",
"authorized_official_last_name": "EAKIN",
"authorized_official_first_name": "JAMES",
"authorized_official_middle_name": "KENDALL",
"authorized_official_title_or_position": "OWNER/PRACTITIONER",
"authorized_official_telephone_number": "509-969-3908",
"authorized_official_credential": "DNP, ARNP, 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": "State of Mind",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Yakima, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2024; 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.