Provider Demographics
NPI:1619421583
Name:A RIGHT MIND MENTAL WELLNESS LLC
Entity Type:Organization
Organization Name:A RIGHT MIND MENTAL WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:KRALICEK
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:541-808-9599
Mailing Address - Street 1:153 N BROADWAY
Mailing Address - Street 2:
Mailing Address - City:COOS BAY
Mailing Address - State:OR
Mailing Address - Zip Code:97420-1633
Mailing Address - Country:US
Mailing Address - Phone:541-808-9599
Mailing Address - Fax:541-808-9559
Practice Address - Street 1:153 N BROADWAY
Practice Address - Street 2:
Practice Address - City:COOS BAY
Practice Address - State:OR
Practice Address - Zip Code:97420-1633
Practice Address - Country:US
Practice Address - Phone:541-808-9599
Practice Address - Fax:541-808-9559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-09
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty