Provider Demographics
NPI:1912623380
Name:HEALTHY MIND THERAPY
Entity Type:Organization
Organization Name:HEALTHY MIND THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:LPC ASSOCIATE
Authorized Official - Phone:757-773-9543
Mailing Address - Street 1:4400 BUFFALO GAP RD.
Mailing Address - Street 2:SUITE 2900
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79606-2723
Mailing Address - Country:US
Mailing Address - Phone:325-261-3074
Mailing Address - Fax:
Practice Address - Street 1:4400 BUFFALO GAP RD.
Practice Address - Street 2:SUITE 2900
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606-2723
Practice Address - Country:US
Practice Address - Phone:325-261-3074
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-17
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty