Enlightened Mind LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

ENLIGHTENED MIND LLC

Practice address

2837 Walnut St
Port Huron, MI 48060-2162

Phone

(810) 689-4547

NPI assigned

Feb 28, 2023

Last updated

Nov 21, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nathanael William Russell, LMSWNPI 1093344681

Title

Clinical Director

Phone

(810) 689-9633

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, and the practitioner matching its NPPES authorized official.

• Nathanael William Russell, LMSW, QMHP

  • Clinical Social Worker
  • Port Huron, MI
  • NPI 1093344681
  NPD Authorized official

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

{
    "created_epoch": "1677542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763683200000",
    "number": "1912606997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2837 WALNUT ST",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480602162",
            "telephone_number": "810-858-1759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2837 WALNUT ST",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480602162",
            "telephone_number": "810-689-4547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENLIGHTENED MIND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-28",
        "last_updated": "2025-11-21",
        "certification_date": "2025-11-21",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "NATHANAEL",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "810-689-9633",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yehia Ibraham Elsafy, MD
• Emergency Care Specialists of St. Clair County, P. C.
• Emergency Care Specialists of St. Clair County, P.C.
• Kari Empson
• Kaitlyn Marie Enders, B.S.
• Donald D Ernst, D.O.
• Thomas Kevin Ernst, DPM
• Stephanie Evans, LLMSW
• Eye Care Providers of Michigan PC (Eye Care Center of Port Huron)
• Eye Care Providers of Michigan PC (Eye Care Center of Port Huron)

• Clinical Social Worker in Port Huron, MI
• Providers in Port Huron, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2025; 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.