Provider Demographics
NPI:1235851148
Name:CLEARMINDS BEHAVIORAL HEALTH
Entity Type:Organization
Organization Name:CLEARMINDS BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NP
Authorized Official - Prefix:
Authorized Official - First Name:OSARETIN
Authorized Official - Middle Name:
Authorized Official - Last Name:OKORO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-605-9878
Mailing Address - Street 1:1301 E DEBBIE LN STE 102
Mailing Address - Street 2:# 1454
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-3376
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2709 THORNHILL LANE
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76084
Practice Address - Country:US
Practice Address - Phone:214-605-9878
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-16
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty