Centered Mind Health LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

CENTERED MIND HEALTH LLC

Practice address

2054 Classique LN
Tavares, FL 32778-5787

Phone

(407) 913-4974

NPI assigned

Dec 12, 2023

Last updated

Dec 12, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Susan Wambui Gray, RN, APRN, PMHNP-BCNPI 1306070701

Title

Ceo

Phone

(770) 912-8905

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Susan Wambui Gray

  • Psychiatric/Mental Health Nurse Practitioner
  • Orlando, FL
  • NPI 1306070701
  Authorized official Same address or phone

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

{
    "created_epoch": "1702339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702339200000",
    "number": "1417725185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4630 S KIRKMAN RD STE 111",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328112833",
            "telephone_number": "407-913-4974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2054 CLASSIQUE LN",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327785787",
            "telephone_number": "407-913-4974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTERED MIND HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-12",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "WAMBUI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "770-912-8905",
        "authorized_official_credential": "RN, APRN, PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Tavares, FL
• Providers in Tavares, 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 Dec 12, 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.