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Organization
THE IMIND FOUNDATION
Active
Organization
THE IMIND FOUNDATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN KALEL BAKSH LMHC, MCAP (CEO)
(772) 617-6373
Entity
Organization
Contact information
Practice address
145 NW CENTRAL PARK PLZ STE 112, PORT SAINT LUCIE, FL 34986-2482
(772) 617-6373
(844) 440-1724
Mailing address
160 NW CENTRAL PARK PLZ STE 104, PORT SAINT LUCIE, FL 34986-1825
(772) 617-6373
(844) 440-1724
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
2084P0800X
Psychiatry Physician
—
—
Other
Enumeration date
06/01/2024
Last updated
06/01/2024
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