Provider Demographics
NPI:1255658050
Name:SOUND MIND MINISTRIES, LLC
Entity type:Organization
Organization Name:SOUND MIND MINISTRIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:MSW LCSW
Authorized Official - Phone:336-470-3618
Mailing Address - Street 1:304 W 2ND ST
Mailing Address - Street 2:SOUND MIND MINISTRIES, LLC
Mailing Address - City:LEXINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27292-2359
Mailing Address - Country:US
Mailing Address - Phone:336-470-3618
Mailing Address - Fax:
Practice Address - Street 1:304 W 2ND ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:NC
Practice Address - Zip Code:27292-2359
Practice Address - Country:US
Practice Address - Phone:336-470-3618
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-03
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0027881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty