MINDARA MODERN PSYCHIATRY LLC NPI 1124901137

NPI Information

  • NPI: 1124901137
  • Provider Name: MINDARA MODERN PSYCHIATRY LLC
  • Classification: Clinic/Center - 261QM0801X
  • Specialization: Mental Health (Including Community Mental Health Center)
  • Entity Type: Organization
  • Address: 4321 W COLLEGE AVE STE 200
    APPLETON, WI
    ZIP 54914
  • Phone: (920) 664-6630

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NPI Details

MINDARA MODERN PSYCHIATRY LLC is a mental health (including community mental health center) clinic center in Appleton, WI. MINDARA MODERN PSYCHIATRY LLC NPI is 1124901137. The provider is registered as an organization entity type.

The provider's business location address is:

4321 W COLLEGE AVE STE 200
APPLETON, WI
ZIP 54914-968
Phone: (920) 664-6630

The provider's authorized official is Yasleny Baker .
The authorized official title is Owner/pmhnp-bc and has the following contact phone number (920) 664-6630.

The enumeration date for this NPI number is 7/28/2025 and was last updated on 7/28/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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