Brilliant Mind Behavioral Services LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

AP126843 Issued in TX

Legal business name

BRILLIANT MIND BEHAVIORAL SERVICES LLC

Practice address

2770 Main St Ste 211
Frisco, TX 75033-4439

Phone

(469) 618-5703

NPI assigned

Jun 15, 2016

Organization subpart

No

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

Authorized official

Name

Shelmith Mamo, MSN,PMHNP-BCNPI 1194122341

Title

Provider

Phone

(469) 618-5703

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

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.

• Shelmith Mamo, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Frisco, TX
  • NPI 1194122341
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1465948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487548800000",
    "number": "1679923163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2770 MAIN ST STE 211",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750334439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2770 MAIN ST STE 211",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750334439",
            "telephone_number": "469-618-5703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRILLIANT MIND BEHAVIORAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-15",
        "last_updated": "2017-02-20",
        "status": "A",
        "authorized_official_last_name": "MAMO",
        "authorized_official_first_name": "SHELMITH",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "469-618-5703",
        "authorized_official_credential": "MSN,PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "TX",
            "license": "AP126843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Frisco, TX
• Providers in Frisco, TX by specialty
• Community/Behavioral Health Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2017; 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.