National Provider Identifier Database

INTRICATE MIND INSTITUTE LLC
Cognitive & Behavioral

A psychologist who reflects an experimental-clinical approach distinguished by use of principles of human learning and development and theories of cognitive processing to promote meaningful change in maladaptive human behavior and thinking.


Contact Information

INTRICATE MIND INSTITUTE, LLC
3990 OLD TOWN AVE STE A207
SAN DIEGO, CA92110-2967
Phone: 858-205-9809
Fax: 858-205-9809
Website:
Specialty Taxonomy Code
* Cognitive & Behavioral 103TB0200X
Intellectual & Developmental Disabilities 103TM1800X

* Indicates primary specialty

NPI Profile & details for INTRICATE MIND INSTITUTE, LLC

NPI Number 1457638124
Legal business name
LBN
INTRICATE MIND INSTITUTE, LLC
Authorized official MARY BAKER-ERICZEN - (DIRECTOR)
Entity Organization
Organization subpart No
Enumeration date 11/09/2011
Last updated 11/09/2011 - About 15 years ago
Sole proprietor1 Not specified
Identifiers
  • CA License #: PSY17553
  • CA License #: PSY23448

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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