Organization Active NPI

Mind Garden Mental Health Services

  • Psychiatric/Mental Health Nurse Practitioner
  • Cambridge, MA
National Provider Identifier
1346969540
Registry record updated Mar 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
MIND GARDEN MENTAL HEALTH SERVICES
Practice address
245 1St St Ste 1800
Cambridge, MA 02142-1292
Phone
(781) 430-4309
Fax
(781) 205-1614
NPI assigned
Aug 23, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2025

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

Authorized official

Name
Carolyne Mburu- Gerena, PMHNP-BCNPI 1376085548
Title
Owner
Phone
(413) 242-6010

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

245 1St St Ste 1800
Cambridge, MA 02142-1292

Mailing address

220 Fortune Blvd # 1009
Milford, MA 01757-1743
Phone (413) 242-6010

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221103001385 MA Part B Supplier - Clinic/Group Practice 7911374970 Receives reassigned benefits from 1 practitioner
Practice locations: Cambridge, MA

National Provider Directory

National Provider Directory

Locations

220 Fortune Blvd
#1009
Milford, MA 01757

Practitioners & affiliated clinicians

Practitioners 1

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": "1661212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740960000000",
    "number": "1346969540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 FORTUNE BLVD # 1009",
            "city": "MILFORD",
            "state": "MA",
            "postal_code": "017571743",
            "telephone_number": "413-242-6010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 1ST ST STE 1800",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021421292",
            "telephone_number": "781-430-4309",
            "fax_number": "781-205-1614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND GARDEN MENTAL HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-23",
        "last_updated": "2025-03-03",
        "certification_date": "2025-02-24",
        "status": "A",
        "authorized_official_last_name": "MBURU- GERENA",
        "authorized_official_first_name": "CAROLYNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "413-242-6010",
        "authorized_official_credential": "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": []
}

Other providers in Cambridge, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2025; 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.