Organization · Type 2 NPI
Mind Haven Psychiatry PLLC
Psychiatric/Mental Health Nurse Practitioner · Stallings, NC
NPI number
1417742883
Active
Practice location
1981 Stallings Rd
Stallings, NC 28104-1104
Fax (704) 709-5537
Mailing address
4728 Audrey Dr
Winston Salem, NC 27127-6698
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | None listed |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
About NPI 1417742883
Mind Haven Psychiatry PLLC's National Provider Identifier is 1417742883, issued on Apr 14, 2025. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Stallings, NC. The record was last updated on Apr 16, 2026.