Sound Mind Holistic Services LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

SOUND MIND HOLISTIC SERVICES LLC

Practice address

4500 Mercantile Plaza Dr Ste 300
Fort Worth, TX 76137-4206

Phone

(817) 874-0159

NPI assigned

May 12, 2022

Organization subpart

No

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

Authorized official

Name

Nzima Josephine Etta

Title

Ceo

Phone

(817) 874-0159

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.

• Josephine Nzima Etta, APRN-PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Fort Worth, TX
  • NPI 1639761232
  Medicare reassignment NPD

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

{
    "created_epoch": "1652313600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653350400000",
    "number": "1700523693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 MERCANTILE PLAZA DR STE 300",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761374206",
            "telephone_number": "817-874-0159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 MERCANTILE PLAZA DR STE 300",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761374206",
            "telephone_number": "817-874-0159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUND MIND HOLISTIC SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-12",
        "last_updated": "2022-05-24",
        "certification_date": "2022-05-24",
        "status": "A",
        "authorized_official_last_name": "ETTA",
        "authorized_official_first_name": "NZIMA JOSEPHINE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "817-874-0159"
    },
    "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": []
}

• Kathryn Soule, PHD, LPC
• Soumava Sen, DDS, P.C.
• Soumava Sen, DDS, P.C.
• Soumava Sen, DDS, P.C.
• Sound Inpatient Physicians of Texas 1, Inc
• Sound Physicians Anesthesiology of Texas PLLC
• South Eyeworks Group, Inc
• South Script Health Care Inc
• South Side Foot Clinic
• South Side Foot Clinic Inc.

• Psychiatric/Mental Health Nurse Practitioner in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2022; 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.