Marlisha'S Mental Fitness LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

MARLISHA'S MENTAL FITNESS LLC

Doing business as

Mind Haven

Practice address

425 Pinson Rd Ste M
Forney, TX 75126-9774

Phone

(469) 457-2163

Fax

(469) 242-9833

NPI assigned

Jan 22, 2022

Organization subpart

No

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

Authorized official

Name

Mrs. Marlisha Lorraine Thomas, PMHNP-BC

Title

Owner/ Provider

Phone

(662) 440-0301

Specialties & licenses 1

Addresses

Other names 1

• Mind Haven Doing business as

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

{
    "created_epoch": "1642809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644883200000",
    "number": "1831841626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 PINSON RD STE M",
            "city": "FORNEY",
            "state": "TX",
            "postal_code": "751269774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 PINSON RD STE M",
            "city": "FORNEY",
            "state": "TX",
            "postal_code": "751269774",
            "telephone_number": "469-457-2163",
            "fax_number": "469-242-9833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARLISHA'S MENTAL FITNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-22",
        "last_updated": "2022-02-15",
        "certification_date": "2022-02-15",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "MARLISHA",
        "authorized_official_middle_name": "LORRAINE",
        "authorized_official_title_or_position": "OWNER/ PROVIDER",
        "authorized_official_telephone_number": "662-440-0301",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PMHNP-BC"
    },
    "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": [
        {
            "organization_name": "Mind Haven",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mind Haven",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Psychiatric/Mental Health Nurse Practitioner in Forney, TX
• Providers in Forney, 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 Feb 15, 2022; 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.