Mind Team, LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

MIND TEAM, LLC

Practice address

2417 Post Rd
Stevens Point, WI 54481-6124

Phone

(715) 842-9500

NPI assigned

Sep 22, 2022

Organization subpart

Yes

Parent organization

BEHAVIORAL HEALTH CLINIC, LLCAs reported in NPPES

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

Authorized official

Name

Amylyn Serrano

Title

Psychology Technician

Phone

(715) 842-9500

Specialties & licenses 1

Addresses

Part of

Behavioral Health Clinic LLC

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

{
    "created_epoch": "1663804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663804800000",
    "number": "1619690807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 S 36TH AVE",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544013930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2417 POST RD",
            "city": "STEVENS POINT",
            "state": "WI",
            "postal_code": "544816124",
            "telephone_number": "715-842-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND TEAM, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BEHAVIORAL HEALTH CLINIC, LLC",
        "enumeration_date": "2022-09-22",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-21",
        "status": "A",
        "authorized_official_last_name": "SERRANO",
        "authorized_official_first_name": "AMYLYN",
        "authorized_official_title_or_position": "PSYCHOLOGY TECHNICIAN",
        "authorized_official_telephone_number": "715-842-9500"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Stevens Point, WI
• Providers in Stevens Point, WI by specialty
• Clinical Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2022; 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.