Provider Demographics
NPI:1669039327
Name:A MIND ABOVE, A PROFESSIONAL PSYCHOLOGY CORPORATION
Entity Type:Organization
Organization Name:A MIND ABOVE, A PROFESSIONAL PSYCHOLOGY CORPORATION
Other - Org Name:A MIND ABOVE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:EMMERICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-240-6550
Mailing Address - Street 1:1300 E SHAW AVE STE 109
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-7903
Mailing Address - Country:US
Mailing Address - Phone:559-712-8800
Mailing Address - Fax:559-712-8505
Practice Address - Street 1:1300 E SHAW AVE STE 109
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-7903
Practice Address - Country:US
Practice Address - Phone:559-712-8800
Practice Address - Fax:559-712-8505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-28
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty