Provider Demographics
NPI:1578450102
Name:RADIANT MINDS PSYCHIATRY, LLC
Entity type:Organization
Organization Name:RADIANT MINDS PSYCHIATRY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF NURSE PRACTICE
Authorized Official - Prefix:MRS
Authorized Official - First Name:MANJIT
Authorized Official - Middle Name:
Authorized Official - Last Name:SANGHA
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:804-496-2113
Mailing Address - Street 1:PO BOX 3913
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23058-3913
Mailing Address - Country:US
Mailing Address - Phone:804-496-2113
Mailing Address - Fax:
Practice Address - Street 1:12199 GAYLON ROAD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23238-7453
Practice Address - Country:US
Practice Address - Phone:804-496-2113
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-18
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty