NPIMap

Organization Active NPI

Mind Haven Therapy LLC

Doing business as Mind Haven Therapy

  • Mental Health Counselor
  • Brentwood, TN
National Provider Identifier
1417772872
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
MIND HAVEN THERAPY LLC
Doing business as
Mind Haven Therapy
Practice address
1800 Mallory LN Ste D
Brentwood, TN 37027-2818
Phone
(615) 603-1636
NPI assigned
Nov 20, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

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

Authorized official

Name
Delphine BurdickNPI 1548110448
Title
Owner
Phone
(615) 603-1636

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
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

1800 Mallory LN Ste D
Brentwood, TN 37027-2818

Mailing address

1800 Mallory LN Ste D
Brentwood, TN 37027-2818
Phone (615) 603-1636

Other names 1

  • MIND HAVEN THERAPY Doing business as

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": "1732060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732060800000",
    "number": "1417772872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 MALLORY LN STE D",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370272818",
            "telephone_number": "615-603-1636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 MALLORY LN STE D",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370272818",
            "telephone_number": "615-603-1636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND HAVEN THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-20",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A",
        "authorized_official_last_name": "BURDICK",
        "authorized_official_first_name": "DELPHINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "615-603-1636"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MIND HAVEN THERAPY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brentwood, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 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.