Provider Demographics
NPI:1174288864
Name:IT'S A BEAUTIFUL MIND CONSULTANTS LLC
Entity type:Organization
Organization Name:IT'S A BEAUTIFUL MIND CONSULTANTS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:JASCHANDRIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:FNP, PMHNP
Authorized Official - Phone:318-243-2411
Mailing Address - Street 1:PO BOX 4132
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71134-0132
Mailing Address - Country:US
Mailing Address - Phone:318-243-2411
Mailing Address - Fax:318-374-2506
Practice Address - Street 1:2924 KNIGHT ST STE 412
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-2413
Practice Address - Country:US
Practice Address - Phone:318-218-5763
Practice Address - Fax:318-374-2506
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-08
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2404580Medicaid