Organization Active NPI

Mind Haven Psychiatry PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Stallings, NC
National Provider Identifier
1417742883
Registry record updated Apr 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
MIND HAVEN PSYCHIATRY PLLC
Practice address
1981 Stallings Rd
Stallings, NC 28104-1104
Phone
(704) 709-5515
Fax
(704) 709-5537
NPI assigned
Apr 14, 2025
Last updated
Apr 16, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2026

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

Authorized official

Name
Jasmine McEntyre, DNP,FNP-BC,PMHNP-BCNPI 1871145912
Title
NP/Pmhnp
Phone
(828) 318-4551

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 Practitioner 363LP0808X Primary

Addresses

Primary practice location

1981 Stallings Rd
Stallings, NC 28104-1104

Mailing address

4728 Audrey Dr
Winston Salem, NC 27127-6698
Phone (828) 318-4551

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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1744588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776297600000",
    "number": "1417742883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4728 AUDREY DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271276698",
            "telephone_number": "828-318-4551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1981 STALLINGS RD",
            "city": "STALLINGS",
            "state": "NC",
            "postal_code": "281041104",
            "telephone_number": "704-709-5515",
            "fax_number": "704-709-5537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND HAVEN PSYCHIATRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-14",
        "last_updated": "2026-04-16",
        "certification_date": "2026-04-16",
        "status": "A",
        "authorized_official_last_name": "MCENTYRE",
        "authorized_official_first_name": "JASMINE",
        "authorized_official_title_or_position": "NP/PMHNP",
        "authorized_official_telephone_number": "828-318-4551",
        "authorized_official_credential": "DNP,FNP-BC,PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stallings, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2026; 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.