Provider Demographics
NPI:1437981164
Name:BTWINS MENTAL HEALTH PSC
Entity type:Organization
Organization Name:BTWINS MENTAL HEALTH PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAELINA
Authorized Official - Middle Name:AFI
Authorized Official - Last Name:BAMAH
Authorized Official - Suffix:
Authorized Official - Credentials:CNP, APRN, PMHNP-BC
Authorized Official - Phone:612-488-6601
Mailing Address - Street 1:21897 S DIAMOND LAKE RD STE 400
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:MN
Mailing Address - Zip Code:55374-4647
Mailing Address - Country:US
Mailing Address - Phone:612-488-6601
Mailing Address - Fax:612-488-6402
Practice Address - Street 1:11670 FOUNTAINS DR STE 200
Practice Address - Street 2:
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55369-7195
Practice Address - Country:US
Practice Address - Phone:612-488-6601
Practice Address - Fax:612-488-6402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-20
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty