Provider Demographics
NPI:1174384275
Name:INTUITIVE MIND BEHAVIORAL HEALTH PLLC
Entity type:Organization
Organization Name:INTUITIVE MIND BEHAVIORAL HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIC NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:LYDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:KIMELI-POPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-242-1744
Mailing Address - Street 1:387 W MILL ST
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-7942
Mailing Address - Country:US
Mailing Address - Phone:830-302-4097
Mailing Address - Fax:
Practice Address - Street 1:457 LANDA ST STE A-25
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-5417
Practice Address - Country:US
Practice Address - Phone:830-302-4097
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-17
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty