Provider Demographics
NPI:1033965793
Name:NOVAMIND THERAPY GROUP LLC
Entity type:Organization
Organization Name:NOVAMIND THERAPY GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:MPSY
Authorized Official - Phone:787-207-7588
Mailing Address - Street 1:VILLA CARIBE
Mailing Address - Street 2:257 VIA CAMPINA
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00727
Mailing Address - Country:US
Mailing Address - Phone:787-207-7588
Mailing Address - Fax:
Practice Address - Street 1:5 CARR 798 KM 0.5
Practice Address - Street 2:RIO CANAS
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-0000
Practice Address - Country:US
Practice Address - Phone:787-207-7588
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-24
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty