Provider Demographics
NPI:1710505797
Name:SPRUCE MIND, LLC
Entity Type:Organization
Organization Name:SPRUCE MIND, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:
Authorized Official - Last Name:LINDON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:540-680-9848
Mailing Address - Street 1:3033 WILSON BLVD STE 700
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22201-3868
Mailing Address - Country:US
Mailing Address - Phone:540-680-9848
Mailing Address - Fax:540-380-8442
Practice Address - Street 1:3033 WILSON BLVD STE 700
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22201-3868
Practice Address - Country:US
Practice Address - Phone:540-680-9848
Practice Address - Fax:540-380-8442
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-07
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)