MYNDSPACE MENTAL HEALTH EDUCATION & CONSULTING, LLC (NPI# 1215541669) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215541669 |
| Entity Type | Organization |
| Organization Name | MYNDSPACE MENTAL HEALTH EDUCATION & CONSULTING, LLC |
| Practice Address |
111 Bantry Cir Charleston SC 29414-8089 |
| Practice Telephone | 8033518252 |
| Mailing Telephone | 8033518252 |
| Enumeration Date | 2020-09-03 |
| Last Update Date | 2020-09-03 |
| Authorized Official Name | DR. CERRISSA MICHELLE HUGIE (OWNER/PROVIDER) |
| Authorized Official Telephone | 8033518252 |
| Authorized Official Credential | DNP, PMHNP-BC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251S00000X | Community/Behavioral Health | Agencies | ||
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
111 BANTRY CIR |
| City | CHARLESTON |
| State | SC |
| Zip Code | 29414-8089 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902444508 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 3865 West Ashley Circle, Charleston, SC 29414 | 2019-12-13 |
| 1215440169 | Christine Michelle Delcioppo | Nurse Practitioner | 2085 Henry Tecklenburg Dr Fl 2or2, Charleston, SC 29414 | 2017-11-14 |
| 1871013508 | Carolyn Sorenson | Assistant Behavior Analyst | 2218 Hunter Creek Dr, Charleston, SC 29414 | 2017-06-23 |
| 1205387354 | Rachel Klatt | Physical Therapist | 2230 Ashley Crossing Dr., Charleston, SC 29414 | 2016-10-24 |
| 1295286912 | Mary M Butler | Physical Therapy Assistant | 2230 Ashley Crossing Drive, Charleston, SC 29414 | 2016-10-18 |
| 1295104982 | Charlene Barbot | Registered Nurse | 3741 Clover St, Charleston, SC 29414 | 2015-09-23 |
| 1720467525 | Sasha M. Perez | Family Medicine | 3030 Ashley Town Center Dr Ste 102a, Charleston, SC 29414 | 2015-05-26 |
| 1104226240 | Angela Mcinvale | Counselor | 3030 Ashley Town Center Dr., Bldg. B-203, Charleston, SC 29414 | 2014-08-26 |
| 1659790087 | Catherine Jefferson Vanderwerker | Physical Therapist | 3019 Saintsbury Cove Dr, Charleston, SC 29414 | 2014-04-14 |
| 1104266741 | Elizabeth A Burguieres | Psychiatry & Neurology | Scdmh- Charleston Telepsychiatry Office, 706 Orleans Rd, Charleston, SC 29414 | 2013-06-27 |
| Find all providers in zip 29414 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033737903 | Danielle Ledwell | Nurse Practitioner | 109 Bee St Fl 5, Charleston, SC 29401-5703 | 2020-07-08 |
| 1497386155 | Michelle Yvette Pinckney | Nurse Practitioner | 1094 Williams Rd, Charleston, SC 29412-5322 | 2020-01-31 |
| 1912555988 | Carla Ann Warren | Nurse Practitioner | 2079 Charlie Hall Blvd., Charleston, SC 29414-2941 | 2019-09-03 |
| 1053876953 | Wendi Koonce Morse | Nurse Practitioner | 109 Bee St # 575a, Charleston, SC 29401-5703 | 2019-02-05 |
| 1245237254 | Ronita L Pace | Nurse Practitioner | 1064 Gardner Rd, Suite 112, Charleston, SC 29407-5768 | 2005-07-05 |
| 1477173425 | Amy M Millett | Nurse Practitioner | 109 Bee St, Charleston, SC 29401-5703 | 2020-04-20 |
| 1700427663 | Jamie Lynn Bagley | Nurse Practitioner | 109 Bee St, Charleston, SC 29401-5703 | 2019-10-02 |
| 1164063152 | Nazokat Atadjanova | Nurse Practitioner | 109 Bee St, Charleston, SC 29401-5703 | 2019-10-01 |
| 1154977726 | Christina J Ketron | Nurse Practitioner | 109 Bee St, Charleston, SC 29401-5703 | 2019-08-09 |
| 1558923615 | Amanda Eblin | Nurse Practitioner | 67 President St, Charleston, SC 29425-5712 | 2019-06-28 |
| Find all providers in CHARLESTON | ||||
| City | CHARLESTON |
| Zip Code | 29414 |
Please comment or provide details below to improve the information on MYNDSPACE MENTAL HEALTH EDUCATION & CONSULTING, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.