Provider Demographics
NPI:1003568247
Name:A MIND'S JOURNEY, LLC
Entity Type:Organization
Organization Name:A MIND'S JOURNEY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CORY
Authorized Official - Middle Name:
Authorized Official - Last Name:SPEAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-808-5421
Mailing Address - Street 1:PO BOX 1847
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84091-1847
Mailing Address - Country:US
Mailing Address - Phone:801-589-9965
Mailing Address - Fax:801-665-0433
Practice Address - Street 1:9678 SOUTH 700 EAST
Practice Address - Street 2:SUITE 101, 201
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84070-8407
Practice Address - Country:US
Practice Address - Phone:801-589-9965
Practice Address - Fax:801-665-0433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-19
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Single Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty