Provider Demographics
NPI:1821302860
Name:TURN THE MIND, LLC
Entity Type:Organization
Organization Name:TURN THE MIND, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:M
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:201-241-2422
Mailing Address - Street 1:317 GODWIN AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:MIDLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07432-1547
Mailing Address - Country:US
Mailing Address - Phone:201-241-2422
Mailing Address - Fax:201-241-2422
Practice Address - Street 1:317 GODWIN AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:MIDLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:07432-1547
Practice Address - Country:US
Practice Address - Phone:201-241-2422
Practice Address - Fax:201-241-2422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-02
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ4803103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
191508OtherMEDICARE PTAN
191508OtherMEDICARE PTAN