Provider Demographics
NPI:1699543785
Name:MINDSET PSYCHIATRIC
Entity type:Organization
Organization Name:MINDSET PSYCHIATRIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:M
Authorized Official - Last Name:BAYLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-290-3122
Mailing Address - Street 1:1086 BECKTON HTS APT 305
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-6580
Mailing Address - Country:US
Mailing Address - Phone:214-585-2090
Mailing Address - Fax:
Practice Address - Street 1:7222 COMMERCE CENTER DR STE 220
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80919-2631
Practice Address - Country:US
Practice Address - Phone:145-852-0902
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty