Provider Demographics
NPI:1053170886
Name:MINDS-N-MOTION WELLNESS LLC
Entity type:Organization
Organization Name:MINDS-N-MOTION WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:NOVITS
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, FNP-C,PMHNP-C
Authorized Official - Phone:844-408-3998
Mailing Address - Street 1:507 WILCOX RD APT A
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44515-6229
Mailing Address - Country:US
Mailing Address - Phone:740-317-3237
Mailing Address - Fax:330-953-2300
Practice Address - Street 1:10927 MAHONING AVE
Practice Address - Street 2:
Practice Address - City:NORTH JACKSON
Practice Address - State:OH
Practice Address - Zip Code:44451-8705
Practice Address - Country:US
Practice Address - Phone:844-408-3998
Practice Address - Fax:330-953-2300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-14
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty