Provider Demographics
NPI:1770368367
Name:HEALING MINDS COMMUNITY SERVICES LLC
Entity type:Organization
Organization Name:HEALING MINDS COMMUNITY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBERTS PLUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-560-7149
Mailing Address - Street 1:3106 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23707-3427
Mailing Address - Country:US
Mailing Address - Phone:757-560-7149
Mailing Address - Fax:
Practice Address - Street 1:3106 HIGH ST
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23707-3427
Practice Address - Country:US
Practice Address - Phone:757-560-7149
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-30
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty