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Organization
MACNIFICENT MINDS
Active
Organization
MACNIFICENT MINDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEE MACK (NP)
(463) 222-9605
Entity
Organization
Contact information
Practice address
4333 VILLAGE TRACE CT, INDIANAPOLIS, IN 46254-6232
(463) 363-1212
(559) 238-0478
Mailing address
3410 N HIGH SCHOOL RD STE G, INDIANAPOLIS, IN 46224-1100
(463) 222-9605
(317) 342-8372
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
08/05/2025
Last updated
07/07/2026
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