Provider Demographics
NPI:1982245148
Name:MIND MATTERS
Entity Type:Organization
Organization Name:MIND MATTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DNP PMHNP-BC
Authorized Official - Prefix:
Authorized Official - First Name:SHERRA
Authorized Official - Middle Name:
Authorized Official - Last Name:STCLAIR
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:307-316-4410
Mailing Address - Street 1:464 N 5TH ST
Mailing Address - Street 2:
Mailing Address - City:LARAMIE
Mailing Address - State:WY
Mailing Address - Zip Code:82072-3137
Mailing Address - Country:US
Mailing Address - Phone:307-630-8798
Mailing Address - Fax:
Practice Address - Street 1:121 E GRAND AVE STE 204
Practice Address - Street 2:
Practice Address - City:LARAMIE
Practice Address - State:WY
Practice Address - Zip Code:82070-3600
Practice Address - Country:US
Practice Address - Phone:307-630-8798
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-30
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty