Provider Demographics
NPI:1972339414
Name:SOUNDMINDS PSYCHIATRY LLC
Entity type:Organization
Organization Name:SOUNDMINDS PSYCHIATRY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIC NURSE PRACTITIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:ADEKEMI
Authorized Official - Middle Name:PSYCHIATRY
Authorized Official - Last Name:SHODUNKE
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:508-579-7021
Mailing Address - Street 1:792 S MAIN ST STE 104
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02048-3137
Mailing Address - Country:US
Mailing Address - Phone:508-579-7021
Mailing Address - Fax:
Practice Address - Street 1:792 S MAIN ST STE 104
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:MA
Practice Address - Zip Code:02048-3137
Practice Address - Country:US
Practice Address - Phone:413-305-2500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-11
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty