# MR. TOM MOGONDO

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1407338031
- **Gender:** Man
- **Credential:** MSN, ARNP-PMHNP-BC

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | 42009.1847 | WY | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | 78352 | KS | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | G155679 | IA | — |

## Other

- **Enumeration date:** 08/30/2018
- **Last updated:** 09/29/2025