Organization
MYND THERA PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLAS MISCHEL MD (OWNER)
(313) 516-7143
Entity
Organization
Contact information
Practice address
19815 MACK AVE STE B, GROSSE POINTE WOODS, MI 48236-2505
(313) 516-7143
Mailing address
19815 MACK AVE STE B, GROSSE POINTE WOODS, MI 48236-2505
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
02/10/2025
Last updated
02/10/2025
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