Organization Active NPI

Mind Matters-Nurse Practitioner in Psychiatry, PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Staten Island, NY
National Provider Identifier
1417879651
Registry record updated Jul 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
MIND MATTERS-NURSE PRACTITIONER IN PSYCHIATRY, PLLC
Practice address
1360 Hylan Blvd
Staten Island, NY 10305-1922
Phone
(347) 766-2155
Fax
(949) 909-2221
NPI assigned
Jul 28, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2026

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

Authorized official

Name
Tara Courtney Callow, PMHNP
Title
Owner/Managing Member
Phone
(347) 766-2155

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

1360 Hylan Blvd
Staten Island, NY 10305-1922

Mailing address

1885 Hylan Blvd Ste 1055
Staten Island, NY 10305-2110
Phone (347) 766-2155

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1785196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785196800000",
    "number": "1417879651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1885 HYLAN BLVD STE 1055",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103052110",
            "telephone_number": "347-766-2155",
            "fax_number": "949-909-2221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 HYLAN BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103051922",
            "telephone_number": "347-766-2155",
            "fax_number": "949-909-2221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND MATTERS-NURSE PRACTITIONER IN PSYCHIATRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-07-28",
        "last_updated": "2026-07-28",
        "certification_date": "2026-07-28",
        "status": "A",
        "authorized_official_last_name": "CALLOW",
        "authorized_official_first_name": "TARA",
        "authorized_official_middle_name": "COURTNEY",
        "authorized_official_title_or_position": "OWNER/MANAGING MEMBER",
        "authorized_official_telephone_number": "347-766-2155",
        "authorized_official_credential": "PMHNP"
    },
    "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 Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 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.