# MIND OVER MATTERS THERAPEUTIC & WELLNESS SERVICES, LLC

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

## Provider details

- **NPI number:** 1265271639
- **Authorized official:** MRS. SHARONDA LASHAWN BAGWELL MSN, CNP, PMHNP (OWNER)
- **Authorized official phone:** (774) 209-2372

## Contact information

- **Practice address:** 109 RHODE ISLAND RD, LAKEVILLE, MA 02347-1370
- **Practice address phone:** (774) 209-2372
- **Mailing address:** 109 RHODE ISLAND RD STE 4B, LAKEVILLE, MA 02347-1370
- **Mailing address phone:** (774) 209-2372
- **Mailing address fax:** (774) 217-7242

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 104100000X | Social Worker | — | NULL | — |
| 104100000X | Social Worker | — | — | — |
| 1041C0700X | Clinical Social Worker | — | NULL | — |
| 1041C0700X | Clinical Social Worker | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 05/23/2024
- **Last updated:** 04/28/2026