Mind Over Mood LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

MIND OVER MOOD LLC

Practice address

10 Berkley Rd
Broomall, PA 19008-2413

Phone

(610) 978-6677

Fax

(610) 672-4753

NPI assigned

Dec 12, 2023

Organization subpart

No

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

Authorized official

Name

Miss Jamie Kakkanattu, CRNPNPI 1982201315

Title

Owner

Phone

(610) 978-6677

Specialties & licenses 1

Addresses

Practitioners 1

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

• Jamie Kakkanattu, CRNP

  • Family Nurse Practitioner
  • Philadelphia, PA
  • NPI 1982201315
  NPD Authorized official

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

{
    "created_epoch": "1702339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702944000000",
    "number": "1750159497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 BERKLEY RD",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "190082413",
            "telephone_number": "610-978-6677",
            "fax_number": "610-672-4753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 BERKLEY RD",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "190082413",
            "telephone_number": "610-978-6677",
            "fax_number": "610-672-4753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND OVER MOOD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-12",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A",
        "authorized_official_last_name": "KAKKANATTU",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "610-978-6677",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "CRNP"
    },
    "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": []
}

• Forest Daniel Miller, OTR/L
• Jeffrey Nelson Miller, DMD
• Kelsey Jane Miller
• Shivaun Miller
• Susan Miller, MD
• Ericka N Mitchell
• Mallory Lynne Mizvitowicz, CRNP
• Molly Elizabeth Modica, LMFT
• Mark A. Monaco, D.O.
• Brenna Catherine Montgomery, BEHAVIOR TECHNICIAN

• Psychiatric/Mental Health Nurse Practitioner in Broomall, PA
• Providers in Broomall, PA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2023; 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.