# IDEAL MINDSET LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083317598
- **Authorized official:** DR. SARAH T PORTER DNP, APRN, PMHNP-BC (REGISTERED AGENT/MEMBER)
- **Authorized official phone:** (801) 999-1384

## Contact information

- **Practice address:** STAPLES CONNECT OGDEN 0703, 4043 RIVERDALE RD. \#1138, OGDEN, UT 84405
- **Practice address phone:** (801) 999-1384
- **Practice address fax:** (385) 364-4055
- **Mailing address:** STAPLES CONNECT OGDEN 0703, 4043 RIVERDALE RD. \#1138, OGDEN, UT 84405
- **Mailing address phone:** (801) 999-1384
- **Mailing address fax:** (385) 364-4055

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084S0012X | Sleep Medicine (Psychiatry & Neurology) Physician | — | NULL | — |
| 2084S0012X | Sleep Medicine (Psychiatry & Neurology) Physician | — | — | — |
| 261QM0850X | Adult Mental Health Clinic/Center | — | NULL | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 03/23/2023
- **Last updated:** 04/28/2023