Renewed Mind - Mental Health LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

RENEWED MIND - MENTAL HEALTH LLC

Practice address

130 S Indian River Dr Ste 202
Fort Pierce, FL 34950-4353

Phone

(772) 812-0168

NPI assigned

Jul 13, 2023

Organization subpart

No

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

Authorized official

Name

Toussaint Golding

Title

Owner of Entity

Phone

(772) 812-0168

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1689206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689206400000",
    "number": "1346929668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 S INDIAN RIVER DR STE 202",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349504353",
            "telephone_number": "772-812-0168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 S INDIAN RIVER DR STE 202",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349504353",
            "telephone_number": "772-812-0168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEWED MIND - MENTAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-13",
        "last_updated": "2023-07-13",
        "certification_date": "2023-07-13",
        "status": "A",
        "authorized_official_last_name": "GOLDING",
        "authorized_official_first_name": "TOUSSAINT",
        "authorized_official_title_or_position": "OWNER OF ENTITY",
        "authorized_official_telephone_number": "772-812-0168"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Fort Pierce, FL
• Providers in Fort Pierce, FL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2023; 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.