Provider Demographics
NPI:1568295681
Name:WELL MINDED PSYCHOLOGY, PLLC
Entity type:Organization
Organization Name:WELL MINDED PSYCHOLOGY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEOSHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:WORTHY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:404-823-3342
Mailing Address - Street 1:75 W END AVE APT C19F
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-7865
Mailing Address - Country:US
Mailing Address - Phone:404-823-3342
Mailing Address - Fax:
Practice Address - Street 1:75 W END AVE APT C19F
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-7865
Practice Address - Country:US
Practice Address - Phone:404-823-3342
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-23
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty