Provider Demographics
NPI:1174905335
Name:QUIET MIND PSYCHOTHERAPEUTIC SERVICES, INC.
Entity type:Organization
Organization Name:QUIET MIND PSYCHOTHERAPEUTIC SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT/CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:SUEANN
Authorized Official - Middle Name:FAITH
Authorized Official - Last Name:SCHWILLE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:540-252-4997
Mailing Address - Street 1:1514 HILLCREST DR
Mailing Address - Street 2:
Mailing Address - City:FRONT ROYAL
Mailing Address - State:VA
Mailing Address - Zip Code:22630-2938
Mailing Address - Country:US
Mailing Address - Phone:540-252-4997
Mailing Address - Fax:540-551-3294
Practice Address - Street 1:11 WATER ST
Practice Address - Street 2:
Practice Address - City:FRONT ROYAL
Practice Address - State:VA
Practice Address - Zip Code:22630-3001
Practice Address - Country:US
Practice Address - Phone:540-252-4997
Practice Address - Fax:540-551-3294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-24
Last Update Date:2015-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040088701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty