Mind Medicine Inc

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

MIND MEDICINE INC

Practice address

25882 Orchard Lake Rd
Farmington Hills, MI 48336-1292

Phone

(248) 426-7299

NPI assigned

Apr 15, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Timothy Chapman, MDNPI 1023056199

Title

Ceo

Phone

(248) 686-4469

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/23255/brand/1/csg/1/fhir/r4

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Timothy L Chapman, MD

  • Psychiatry Physician
  • Farmington Hills, MI
  • NPI 1023056199
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1618444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618444800000",
    "number": "1376124925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8171",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483028171",
            "telephone_number": "248-686-4469",
            "fax_number": "248-927-5191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25882 ORCHARD LAKE RD",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483361292",
            "telephone_number": "248-426-7299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND MEDICINE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-15",
        "last_updated": "2021-04-15",
        "certification_date": "2021-04-15",
        "status": "A",
        "authorized_official_last_name": "CHAPMAN",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "248-686-4469",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mercedes Mincey, RBT
• Rayona Mincey
• Tomisha Mincey
• Mind Body and Soul Psychiatric Services
• Mind Body and Soul Psychiatric Services
• Mind Reset Therapy
• Laura Shira Mindell, LPC
• Steven Minden
• Mindful Changes, PLLC
• Mindful Psychotherapy Services PC

• Mental Health Clinic/Center (Including Community Mental Health Center) in Farmington Hills, MI
• Providers in Farmington Hills, MI by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2021; 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.