Organization Active NPI

State of Mind

  • Psychiatric/Mental Health Nurse Practitioner
  • Yakima, WA
National Provider Identifier
1154160604
Registry record updated May 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
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

Updated by the provider on May 23, 2024

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-BCNPI 1023688769
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)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 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 Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260417002578 WA Part B Supplier - Clinic/Group Practice 9335615236 Receives reassigned benefits from 3 practitioners
Practice locations: Yakima, WA

National Provider Directory

National Provider Directory

Locations

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.

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.

Verify at the official NPI Registry.