Provider Demographics
NPI:1033974951
Name:KIND MIND MENTAL HEALTH PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:KIND MIND MENTAL HEALTH PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TABATHA
Authorized Official - Middle Name:
Authorized Official - Last Name:TRUELOVE
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC, APRN
Authorized Official - Phone:918-913-7575
Mailing Address - Street 1:655 E OKMULGEE ST
Mailing Address - Street 2:
Mailing Address - City:MUSKOGEE
Mailing Address - State:OK
Mailing Address - Zip Code:74403-5529
Mailing Address - Country:US
Mailing Address - Phone:918-913-7575
Mailing Address - Fax:
Practice Address - Street 1:655 E OKMULGEE ST
Practice Address - Street 2:
Practice Address - City:MUSKOGEE
Practice Address - State:OK
Practice Address - Zip Code:74403-5529
Practice Address - Country:US
Practice Address - Phone:918-913-7575
Practice Address - Fax:918-913-7576
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-20
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty