Organization Active NPI

Essence of the Mind Behavioral Health and Wellness

  • Psychiatric/Mental Health Nurse Practitioner
  • Greenville, SC
National Provider Identifier
1376304063
Registry record updated Apr 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
ESSENCE OF THE MIND BEHAVIORAL HEALTH AND WELLNESS
Practice address
25 Woods Lake Rd Ste 321
Greenville, SC 29607-2762
Phone
(864) 208-9501
Fax
(864) 849-7759
NPI assigned
Jan 19, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2024

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

Authorized official

Name
Tandi W Fortier, APRNNPI 1205494580
Title
Psychiatric Mental Health NP
Phone
(864) 208-9501

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

25 Woods Lake Rd Ste 321
Greenville, SC 29607-2762

Mailing address

25 Woods Lake Rd Ste 321
Greenville, SC 29607-2762
Phone (864) 208-9501

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240819002332 SC Part B Supplier - Clinic/Group Practice 7911445150 Receives reassigned benefits from 1 practitioner
Practice locations: Greenville, SC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1705622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713657600000",
    "number": "1376304063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 WOODS LAKE RD STE 321",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296072762",
            "telephone_number": "864-208-9501",
            "fax_number": "864-849-7759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 WOODS LAKE RD STE 321",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296072762",
            "telephone_number": "864-208-9501",
            "fax_number": "864-849-7759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESSENCE OF THE MIND BEHAVIORAL HEALTH AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-19",
        "last_updated": "2024-04-21",
        "certification_date": "2024-04-21",
        "status": "A",
        "authorized_official_last_name": "FORTIER",
        "authorized_official_first_name": "TANDI",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PSYCHIATRIC MENTAL HEALTH NP",
        "authorized_official_telephone_number": "864-208-9501",
        "authorized_official_credential": "APRN"
    },
    "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 Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 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.