1. Home
  2. Directory
  3. New Mexico
  4. Albuquerque
  5. Nurse Practitioner
  6. NPI Profile

MIND MEDICINE CLINIC
NPI 1194402503
Nurse Practitioner - Psychiatric/Mental Health in Albuquerque, NM

Active since June 28, 2023
1608 5TH ST NW, ALBUQUERQUE, NM 87102(312) 882-0432 Get Directions Write a Review

NPPES record last updated: February 16, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Mind Medicine Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MIND MEDICINE CLINIC (NPI 1194402503) is a healthcare organization registered as a psychiatric/mental health in Albuquerque, New Mexico and active in the NPI registry since June 2023. The organization lists Rebeccah S Lyles, Owner/provider, as its authorized official.

NPPES Registry Identity

NPI1194402503
Entity TypeOrganization
Primary Taxonomy363LP0808X
Legal Business NameMIND MEDICINE CLINIC LLC
Location Address1608 5TH ST NWAlbuquerque, NM 87102-1302
Mailing Address1608 5th St NwAlbuquerque, NM 87102-1302
Phone(312) 882-0432
Organization SubpartNo
Authorized OfficialRebeccah S LylesOwner/provider · (312) 882-0432
Enumeration DateJune 28, 2023
Last NPPES UpdateFebruary 16, 2024
NPPES CertifiedJanuary 23, 2024
✔ NPI 1194402503 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
1608 5TH ST NW, Albuquerque, NM 87102
Open in Google Maps ↗

Other Names 1

Doing Business AsMind Medicine Clinic

Other Identifiers 2

Medicaid545-245-63NM
Other1659066512Individual Npi

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. REBECCAH SUSANNE LYLES PMH-DNP
Nurse Practitioner (Psychiatric/Mental Health)
1608 5TH ST NW
ALBUQUERQUE, NM 87102
Bernalillo County (312) 882-0432
KYLA HENDERSON MSW, LCSW
Social Worker (Clinical)
1608 5TH ST NW
ALBUQUERQUE, NM 87102
Bernalillo County (312) 882-0432

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mind Medicine Clinic LLC's NPI number?

The NPI number for Mind Medicine Clinic LLC is 1194402503. It was assigned to this organization in the NPPES registry on June 28, 2023. The provider is doing business as Mind Medicine Clinic.

Where is Mind Medicine Clinic LLC located?

Mind Medicine Clinic LLC is located at 1608 5th St NW, Albuquerque, NM 87102. The listed phone number is (312) 882-0432.

What is Mind Medicine Clinic LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

When was this NPI record last updated?

The NPPES record for Mind Medicine Clinic LLC was last updated on February 16, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.