Provider Demographics
NPI:1629474770
Name:HEALTHY MINDS OF DELAWARE LLC
Entity Type:Organization
Organization Name:HEALTHY MINDS OF DELAWARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:BETHANY
Authorized Official - Middle Name:
Authorized Official - Last Name:HAWKINS PARRY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:302-644-2773
Mailing Address - Street 1:18947 JOHN J WILLIAMS HWY
Mailing Address - Street 2:STE 210
Mailing Address - City:REHOBOTH BEACH
Mailing Address - State:DE
Mailing Address - Zip Code:19971-4474
Mailing Address - Country:US
Mailing Address - Phone:302-644-2773
Mailing Address - Fax:302-644-1737
Practice Address - Street 1:18947 JOHN J WILLIAMS HWY
Practice Address - Street 2:STE 210
Practice Address - City:REHOBOTH BEACH
Practice Address - State:DE
Practice Address - Zip Code:19971-4474
Practice Address - Country:US
Practice Address - Phone:302-644-2773
Practice Address - Fax:302-644-1737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-17
Last Update Date:2014-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ100008311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty