Healthy Mind & Brain Center Licensed Clinical Social Worker in.

Primary specialty

Neuropathology PhysicianTaxonomy code 207ZN0500X

Legal business name

HEALTHY MIND & BRAIN CENTER LICENSED CLINICAL SOCIAL WORKER IN.

Doing business as

Healthy Mind & Brain Center

Practice address

16195 Siskiyou Rd Ste 120B
Apple Valley, CA 92307-1346

Phone

(190) 983-1044

NPI assigned

Mar 13, 2020

Last updated

Feb 16, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Regina J Peacock, LCSWNPI 1053916965

Title

Ceo

Phone

(909) 831-0446

Specialties & licenses 1

Addresses

Other names 2

• Healthy Mind & Brain Center Doing business as
• Brain Core Former legal business name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Regina Joanna Peacock, LCSW

  • Clinical Social Worker
  • Rialto, CA
  • NPI 1053916965
  Medicare reassignment NPD Authorized official
• Sheila Maria Mendoza-Cordero, LCSW

  • Clinical Social Worker
  • San Bernardino, CA
  • NPI 1215521943
  NPD
• Cheryl Lynne Posey, LCSW

  • Clinical Social Worker
  • Redlands, CA
  • NPI 1750017588

  Single Specialty

  NPD

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

{
    "created_epoch": "1584057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644969600000",
    "number": "1255967063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5822 OLIVE AVE",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "923773964",
            "telephone_number": "909-831-0446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16195 SISKIYOU RD STE 120B",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923071346",
            "telephone_number": "190-983-1044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHY MIND & BRAIN CENTER LICENSED CLINICAL SOCIAL WORKER IN.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-13",
        "last_updated": "2022-02-16",
        "certification_date": "2022-02-16",
        "status": "A",
        "authorized_official_last_name": "PEACOCK",
        "authorized_official_first_name": "REGINA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "909-831-0446",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "207ZN0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Neuropathology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Healthy Mind & Brain Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Brain Core",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• John Raymond Hawes Jr., DO
• Asa Hawkins, R.C.P
• Jody M Hawn
• Sara Works Headen
• Healing Waters Marriage and Family Therapy Inc
• Healthy People Medical Associates, Inc.
• Heather Navarro, Licensed Clinical Social Worker, Inc.
• Heaven's Heritage Inc. (Tajanta Care Homes)
• Pearl Heft, PA
• Terry Helin, COTA/L

• Neuropathology Physician in Apple Valley, CA
• Providers in Apple Valley, CA by specialty
• Neuropathology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2022; 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.