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Contact Information

MY MIND MATTERS
34 JEROME AVE STE 116
BLOOMFIELD, CT06002-2463
 Phone: 860-386-8034
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

1041C0700X 80 Licensed Clinical Social Worker
 

Art Therapist

221700000X
 

Health & Wellness Coach

171400000X
 

School

1041S0200X
 

Social Worker

104100000X
Indicates primary specialty

NPI Profile & details for MY MIND MATTERS

NPI Number 1316625080
LBN Legal business name MY MIND MATTERS
Authorized official DR. KENIESHA JOHNSON - (OWNER)
Entity Organization
Organization subpart 1 Yes
Enumeration date 07/11/2023
Last updated 07/11/2023 - About 3 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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