Innovation Mind and Health LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

INNOVATION MIND AND HEALTH LLC

Practice address

2263 Villa Verano Way Apt 102
Kissimmee, FL 34744-5982

Phone

(407) 744-5447

NPI assigned

Sep 1, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Ingris Maldonado, LMHC- PHDNPI 1265933352

Title

Owner

Phone

(407) 744-5447

Specialties & licenses 3

Addresses

Other names 1

• Innovation Mind Health Services Doing business as

Practitioners 1

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

• Ingris Maldonado, PHD-MHLC

  • Counseling Psychologist
  • St. Cloud, FL
  • NPI 1265933352
  NPD (past) Authorized official

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

{
    "created_epoch": "1661990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712016000000",
    "number": "1821718529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1257 SPOKANE PT",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347416437",
            "telephone_number": "407-744-5447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2263 VILLA VERANO WAY APT 102",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347445982",
            "telephone_number": "407-744-5447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATION MIND AND HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-01",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A",
        "authorized_official_last_name": "MALDONADO",
        "authorized_official_first_name": "INGRIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-744-5447",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "LMHC- PHD"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Innovation Mind Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Adult Mental Health Clinic/Center in Kissimmee, FL
• Providers in Kissimmee, FL by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2024; 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.