Provider Demographics
NPI:1518647940
Name:FREE YOUR MIND PSYCHIATRIC SERVICES, LLC
Entity Type:Organization
Organization Name:FREE YOUR MIND PSYCHIATRIC SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTA
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:601-695-2282
Mailing Address - Street 1:2718 OLD HIGHWAY 51 NE
Mailing Address - Street 2:
Mailing Address - City:WESSON
Mailing Address - State:MS
Mailing Address - Zip Code:39191-9446
Mailing Address - Country:US
Mailing Address - Phone:601-695-2282
Mailing Address - Fax:
Practice Address - Street 1:2718 OLD HIGHWAY 51 NE
Practice Address - Street 2:
Practice Address - City:WESSON
Practice Address - State:MS
Practice Address - Zip Code:39191-9446
Practice Address - Country:US
Practice Address - Phone:601-695-2282
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-20
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty