Organization Active NPI

Mindful Creations

  • Psychiatric/Mental Health Nurse Practitioner
  • Mesa, AZ
National Provider Identifier
1861218422
Registry record updated Dec 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
MINDFUL CREATIONS
Practice address
2157 E Emelita Ave
Mesa, AZ 85204-4519
Phone
(773) 395-8779
NPI assigned
Nov 28, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2024

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

Authorized official

Name
Ms. Terri Collins, PMHNP-BC, MSN-ED,NPI 1831702513
Title
Psychiatric Nurse Practitioner
Phone
(773) 395-8779

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

2157 E Emelita Ave
Mesa, AZ 85204-4519

Mailing address

PO Box 6095
Mesa, AZ 85216-6095
Phone (773) 395-8779

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250509002059 AZ Part B Supplier - Clinic/Group Practice 4486171790 Receives reassigned benefits from 1 practitioner
Practice locations: Mesa, AZ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1732752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734652800000",
    "number": "1861218422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6095",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852166095",
            "telephone_number": "773-395-8779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2157 E EMELITA AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852044519",
            "telephone_number": "773-395-8779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL CREATIONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-28",
        "last_updated": "2024-12-20",
        "certification_date": "2024-12-20",
        "status": "A",
        "authorized_official_last_name": "COLLINS",
        "authorized_official_first_name": "TERRI",
        "authorized_official_title_or_position": "PSYCHIATRIC NURSE PRACTITIONER",
        "authorized_official_telephone_number": "773-395-8779",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PMHNP-BC, MSN-ED,"
    },
    "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": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2024; 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.