Provider Demographics
NPI:1265203285
Name:SOUND MIND, INC.
Entity type:Organization
Organization Name:SOUND MIND, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:304-712-0775
Mailing Address - Street 1:PO BOX 63
Mailing Address - Street 2:
Mailing Address - City:LESTER
Mailing Address - State:WV
Mailing Address - Zip Code:25865-0063
Mailing Address - Country:US
Mailing Address - Phone:304-712-0775
Mailing Address - Fax:
Practice Address - Street 1:1970 LESTER HIGHWAY
Practice Address - Street 2:
Practice Address - City:LESTER
Practice Address - State:WV
Practice Address - Zip Code:25865
Practice Address - Country:US
Practice Address - Phone:304-712-0775
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-09
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health