Provider Demographics
NPI:1659248672
Name:MINDSTEAD INTEGRATIVE PSYCHIATRY, LLC
Entity type:Organization
Organization Name:MINDSTEAD INTEGRATIVE PSYCHIATRY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BREWER
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:307-212-9200
Mailing Address - Street 1:1621 CENTRAL AVE # 56902
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82001-4531
Mailing Address - Country:US
Mailing Address - Phone:307-212-9200
Mailing Address - Fax:
Practice Address - Street 1:1621 CENTRAL AVE # 56902
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-4531
Practice Address - Country:US
Practice Address - Phone:814-331-1792
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-23
Last Update Date:2025-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health