Mindcare Agency PC

Primary specialty

Addiction Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084A0401X

License

223674 Issued in MA

Legal business name

MINDCARE AGENCY PC

Practice address

125 Liberty St
Suite 205
Springfield, MA 01103-1114

Phone

(413) 271-7136

Fax

(413) 271-7137

NPI assigned

Sep 3, 2015

Organization subpart

No

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

Authorized official

Name

Omar Faruk, MD

Title

Ceo

Phone

(413) 271-7136

Specialties & licenses 3

Addresses

Other identifiers 1

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

{
    "created_epoch": "1441238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574035200000",
    "number": "1730557018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 LIBERTY ST",
            "address_2": "SUITE 205",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011031114",
            "telephone_number": "413-271-7136",
            "fax_number": "413-271-7137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 LIBERTY ST",
            "address_2": "SUITE 205",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011031114",
            "telephone_number": "413-271-7136",
            "fax_number": "413-271-7137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDCARE AGENCY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-03",
        "last_updated": "2019-11-18",
        "status": "A",
        "authorized_official_last_name": "FARUK",
        "authorized_official_first_name": "OMAR",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "413-271-7136",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "MA",
            "license": "223674",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "223674",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Milton
• Marianne Carmela Milton
• Raneem Ghazi Milyani, MD
• Shanese Nicole Mims
• Mercedes Nieves Minaya
• Lisa Anne Mindell
• Oleksandr Mindrov
• Evan Minkin, NP
• Lynn M. Minney, LICSW
• Lynn A Minnick, NP

• Addiction Medicine (Psychiatry & Neurology) Physician in Springfield, MA
• Providers in Springfield, MA by specialty
• Addiction Medicine (Psychiatry & Neurology) Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2019; 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.