Mynd Matters

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

MYND MATTERS

Practice address

9201 Arboretum Pkwy Ste 110
North Chesterfield, VA 23236-5403

Phone

(804) 320-0101

Fax

(804) 320-0808

NPI assigned

Apr 4, 2018

Organization subpart

No

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

Authorized official

Name

David Dameron, PHD

Title

Owner

Phone

(804) 320-0101

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1522800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522800000000",
    "number": "1285130633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9201 ARBORETUM PKWY STE 110",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232365403",
            "telephone_number": "804-320-0101",
            "fax_number": "804-320-0808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9201 ARBORETUM PKWY STE 110",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232365403",
            "telephone_number": "804-320-0101",
            "fax_number": "804-320-0808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYND MATTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-04",
        "last_updated": "2018-04-04",
        "status": "A",
        "authorized_official_last_name": "DAMERON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "804-320-0101",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in North Chesterfield, VA
• Providers in North Chesterfield, VA by specialty
• Clinical Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2018; 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.