Provider Demographics
NPI:1407554827
Name:PURITY OF MINDS
Entity Type:Organization
Organization Name:PURITY OF MINDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:MIYESHA
Authorized Official - Middle Name:CAPRI
Authorized Official - Last Name:SWAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSWA
Authorized Official - Phone:919-593-2469
Mailing Address - Street 1:633 COLLINGTON DR.
Mailing Address - Street 2:
Mailing Address - City:MEBANE
Mailing Address - State:NC
Mailing Address - Zip Code:27302
Mailing Address - Country:US
Mailing Address - Phone:919-593-2469
Mailing Address - Fax:
Practice Address - Street 1:633 COLLINGTON DR.
Practice Address - Street 2:
Practice Address - City:MEBANE
Practice Address - State:NC
Practice Address - Zip Code:27302
Practice Address - Country:US
Practice Address - Phone:919-593-2469
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-16
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty