Organization Active NPI

Soulspring Mindset LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Bloomfield, CT
National Provider Identifier
1407684178
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
SOULSPRING MINDSET LLC
Practice address
17 Quail Run
Bloomfield, CT 06002-1676
Phone
(860) 431-6710
NPI assigned
Jul 24, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

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

Authorized official

Name
Ikenna OkechukwuNPI 1326821935
Title
Pmhnp
Phone
(860) 268-1168

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

17 Quail Run
Bloomfield, CT 06002-1676

Mailing address

17 Quail Run
Bloomfield, CT 06002-1676

National Provider Directory

National Provider Directory

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": "1721779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721779200000",
    "number": "1407684178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 QUAIL RUN",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "060021676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 QUAIL RUN",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "060021676",
            "telephone_number": "860-431-6710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOULSPRING MINDSET LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-24",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A",
        "authorized_official_last_name": "OKECHUKWU",
        "authorized_official_first_name": "IKENNA",
        "authorized_official_title_or_position": "PMHNP",
        "authorized_official_telephone_number": "860-268-1168"
    },
    "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 Bloomfield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2024; 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.