Provider Demographics
NPI:1396578548
Name:CONNECTED THERAPEUTIC MINDS
Entity type:Organization
Organization Name:CONNECTED THERAPEUTIC MINDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANTOINETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:804-715-5651
Mailing Address - Street 1:5935 HOPKINS RD # 201
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23234-5436
Mailing Address - Country:US
Mailing Address - Phone:804-715-5651
Mailing Address - Fax:804-823-2594
Practice Address - Street 1:5935 HOPKINS RD # 201
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23234-5436
Practice Address - Country:US
Practice Address - Phone:804-715-5651
Practice Address - Fax:804-823-2594
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-22
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty