Provider Demographics
NPI:1801678909
Name:COLLABORATING MINDS LLC
Entity type:Organization
Organization Name:COLLABORATING MINDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CHASITY
Authorized Official - Middle Name:J
Authorized Official - Last Name:CARSWELL
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, FNP-C, PMHNP-BC
Authorized Official - Phone:678-226-1475
Mailing Address - Street 1:485 S PERRY ST STE A9
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-4923
Mailing Address - Country:US
Mailing Address - Phone:770-315-8634
Mailing Address - Fax:678-404-8099
Practice Address - Street 1:485 S PERRY ST STE A9
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-4923
Practice Address - Country:US
Practice Address - Phone:782-261-4756
Practice Address - Fax:678-404-8099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-16
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty