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Organization
NOURISHED MINDS LLC
Active
Organization
NOURISHED MINDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MIRANDA MITCHELL APRN (CO-OWNER)
(401) 241-1952
Entity
Organization
Contact information
Practice address
891 MAIN STREET, SUITE 1B, SOUTH GLASTONBURY, CT 06073
(401) 241-1952
Mailing address
56 PETERSEN RD, GRANBY, CT 06035-1902
(401) 241-1952
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1083154850
NPI
—
01
—
1427743889
NPI
—
Enumeration date
07/11/2024
Last updated
01/03/2025
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