Provider Demographics
NPI:1336950658
Name:ADVANCED MIND HEALING & WELLNESS, PLLC
Entity type:Organization
Organization Name:ADVANCED MIND HEALING & WELLNESS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIC MENTAL HEALTH ARNP
Authorized Official - Prefix:MS
Authorized Official - First Name:CAMELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRANARA
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:617-500-5767
Mailing Address - Street 1:51 ELM ST
Mailing Address - Street 2:STE 107 #133
Mailing Address - City:LACONIA
Mailing Address - State:NH
Mailing Address - Zip Code:03246
Mailing Address - Country:US
Mailing Address - Phone:617-500-5767
Mailing Address - Fax:617-415-2708
Practice Address - Street 1:51 ELM STREET
Practice Address - Street 2:
Practice Address - City:LACONIA
Practice Address - State:NH
Practice Address - Zip Code:03246
Practice Address - Country:US
Practice Address - Phone:617-500-5767
Practice Address - Fax:617-415-2708
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-16
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty