Provider Demographics
NPI:1154011617
Name:MASTERING MINDS, LLC
Entity type:Organization
Organization Name:MASTERING MINDS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DERENDA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BEASLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-648-8779
Mailing Address - Street 1:833 W HIGHWAY 25 70
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37821-8045
Mailing Address - Country:US
Mailing Address - Phone:334-648-8779
Mailing Address - Fax:
Practice Address - Street 1:833 W HIGHWAY 25 70
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:TN
Practice Address - Zip Code:37821-8045
Practice Address - Country:US
Practice Address - Phone:334-648-8779
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-09
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty