Mind & Mane LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

MIND & MANE LLC

Practice address

3664 Genesis LN
Wake Forest, NC 27587-6088

Phone

(919) 443-5697

NPI assigned

Jul 21, 2022

Organization subpart

No

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

Authorized official

Name

Zean King

Title

Owner

Phone

(919) 443-5697

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Tax ID family

Mind Mane2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Mind & Mane

  • Adult Mental Health Clinic/Center
  • Wake Forest, NC
  • NPI 1316673163
  NPD tax ID

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Valencia Juanita Sanders-Davis, LPC

  • Mental Health Counselor
  • High Point, NC
  • NPI 1912242173
  Medicare reassignment NPD
• Kiaya Alise Branch, LCSWA

  • Clinical Social Worker
  • Wake Forest, NC
  • NPI 1104798172
  NPD (past)
• Nicole King, LCSW

  • Clinical Social Worker
  • Wake Forest, NC
  • NPI 1700411931
  NPD (past)

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

{
    "created_epoch": "1658361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691712000000",
    "number": "1578298774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3664 GENESIS LN",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275876088",
            "telephone_number": "919-443-5697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3664 GENESIS LN",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275876088",
            "telephone_number": "919-443-5697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND & MANE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-21",
        "last_updated": "2023-08-11",
        "certification_date": "2023-08-11",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "ZEAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-443-5697"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas R Miller Jr., OD
• Alyssa Michelle Mills, M.ED., LPCA, NCC
• Ashley Mills, MS, LCMHCA
• Brittany Dawn Mims, PA-C
• Mind & Mane
• Mind & Mane PLLC
• Mindful Counseling Professionals, PLLC
• Mindscape ABA and Educational Services
• Amy Catherine Minor, LMFT
• Minton Compounding Lab

• Community/Behavioral Health Agency in Wake Forest, NC
• Providers in Wake Forest, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.