Provider Demographics
NPI:1457953283
Name:MIND PLAY, LLC
Entity Type:Organization
Organization Name:MIND PLAY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:KIRKPATRICK
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:937-554-5975
Mailing Address - Street 1:6479 GOOCHLAND ST
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:20187-4175
Mailing Address - Country:US
Mailing Address - Phone:937-554-5975
Mailing Address - Fax:571-415-3002
Practice Address - Street 1:14540 JOHN MARSHALL HWY STE 100
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:VA
Practice Address - Zip Code:20155-1693
Practice Address - Country:US
Practice Address - Phone:540-216-2285
Practice Address - Fax:571-415-3002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-16
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty