Provider Demographics
NPI:1538703830
Name:MIND CONNECTION BEHAVIORAL HEALTH PLLC
Entity Type:Organization
Organization Name:MIND CONNECTION BEHAVIORAL HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:DR
Authorized Official - First Name:OLUWATOSIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ADEBIYI
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, APRN PMHNP-BC
Authorized Official - Phone:888-575-8046
Mailing Address - Street 1:100 GLENBOROUGH DR STE 403
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77067-3600
Mailing Address - Country:US
Mailing Address - Phone:888-575-8046
Mailing Address - Fax:
Practice Address - Street 1:100 GLENBOROUGH DR STE 403
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77067-3600
Practice Address - Country:US
Practice Address - Phone:888-575-8046
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-30
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty