Provider Demographics
NPI:1851260152
Name:ELYSIAN MIND & BODY PLLC
Entity type:Organization
Organization Name:ELYSIAN MIND & BODY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:IREON
Authorized Official - Middle Name:
Authorized Official - Last Name:LEBEAUF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-430-9322
Mailing Address - Street 1:PO BOX 450051
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33345-0051
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1702 S DIXIE HWY
Practice Address - Street 2:
Practice Address - City:LAKE WORTH BEACH
Practice Address - State:FL
Practice Address - Zip Code:33460-5886
Practice Address - Country:US
Practice Address - Phone:959-216-6130
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-04
Last Update Date:2025-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty