Provider Demographics
NPI:1841037280
Name:BRIGHTER MIND THERAPY LLC
Entity type:Organization
Organization Name:BRIGHTER MIND THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BORIS
Authorized Official - Middle Name:NONE
Authorized Official - Last Name:PATENT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-409-6215
Mailing Address - Street 1:7626 1/2 N MILWAUKEE AVE APT 1B
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:IL
Mailing Address - Zip Code:60714-3181
Mailing Address - Country:US
Mailing Address - Phone:847-409-6215
Mailing Address - Fax:
Practice Address - Street 1:7626 1/2 N MILWAUKEE AVE APT 1B
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:IL
Practice Address - Zip Code:60714-3181
Practice Address - Country:US
Practice Address - Phone:847-409-6215
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-12
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty