Provider Demographics
NPI:1033896659
Name:ELEVATED MINDS PSYCHIATRY SERVICES, LLC
Entity Type:Organization
Organization Name:ELEVATED MINDS PSYCHIATRY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:REDENA
Authorized Official - Last Name:WARREN
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:850-688-7217
Mailing Address - Street 1:2241 N MONROE ST # 1604
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32303-4731
Mailing Address - Country:US
Mailing Address - Phone:850-695-8959
Mailing Address - Fax:850-213-6074
Practice Address - Street 1:547 OLD SHELL POINT RD
Practice Address - Street 2:
Practice Address - City:CRAWFORDVILLE
Practice Address - State:FL
Practice Address - Zip Code:32327-5816
Practice Address - Country:US
Practice Address - Phone:850-688-7217
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-05
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty