Mind Haven Behavioral Clinic LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

MIND HAVEN BEHAVIORAL CLINIC LLC

Practice address

733 Highway 287 N Ste 407
Mansfield, TX 76063-3867

Phone

(214) 210-5592

Fax

(505) 212-1939

NPI assigned

Jul 10, 2021

Last updated

Sep 6, 2024By 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

Nonye Frances NwokoroNPI 1811544000

Title

Owner

Phone

(214) 210-5592

Specialties & licenses 1

Addresses

Other names 1

• Mind Haven Behavioral Clinic Former legal business name

Medicare fee-for-service enrollment

Enrolled in NM, TX2 enrollments

Enrollment records 2

Locations

Practitioners 1

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.

• Nonye Nwokoro

  • Psychiatric/Mental Health Nurse Practitioner
  • Mansfield, TX
  • NPI 1811544000

  NM

  Medicare reassignment Authorized official

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

{
    "created_epoch": "1625875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725580800000",
    "number": "1285206250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "733 HIGHWAY 287 N STE 407",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760633867",
            "telephone_number": "214-210-5592",
            "fax_number": "505-212-1939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "733 HIGHWAY 287 N STE 407",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760633867",
            "telephone_number": "214-210-5592",
            "fax_number": "505-212-1939"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1209 Mountain Road Pl NE # 4503",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871107845",
            "country_code": "US",
            "telephone_number": "683-365-0875",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MIND HAVEN BEHAVIORAL CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-10",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A",
        "authorized_official_last_name": "NWOKORO",
        "authorized_official_first_name": "NONYE",
        "authorized_official_middle_name": "FRANCES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "214-210-5592"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mind Haven Behavioral Clinic",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Mind Haven Behavioral Clinic",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Lindsay Miles
• Courtney Miller, APRN-CNP
• Emily Paige Miller, R.N.
• Melissa Miller
• Richard Miller, MD
• Mind-Touch Psychiatry & Integrative Care, LLC
• Mindease Psychiatry, PLLC
• Mindway Behavioral PLLC
• Kimberly A Misamore, MD
• Erica Sylvia Mitchell

• Psychiatric/Mental Health Nurse Practitioner in Mansfield, TX
• Providers in Mansfield, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 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.