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Organization

MIND CULTIVATE INC

Active
Other names
Mind Cultivate
Organization subpart
No

Provider details

NPI number
Authorized official
NAOMI EWANSIHA (MANAGER)
(832) 455-8505
Entity
Organization

Contact information

Practice address
1500 DRAGON ST, DALLAS, TX 75207-3917
(832) 455-8505
Mailing address
2361 E UNIVERSITY DR STE 10, PROSPER, TX 75078-2391
(832) 455-8505

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YM0800X
Mental Health Counselor
101YP1600X
Pastoral Counselor
101YP2500X
Professional Counselor
103K00000X
Behavior Analyst
103T00000X
Psychologist
Primary
103TA0400X
Addiction (Substance Use Disorder) Psychologist
103TA0700X
Adult Development & Aging Psychologist
103TC0700X
Clinical Psychologist
103TC1900X
Counseling Psychologist
103TF0000X
Family Psychologist
106H00000X
Marriage & Family Therapist
106S00000X
Behavior Technician
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)

Other

Enumeration date
09/06/2022
Last updated
10/04/2022
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