Provider Demographics
NPI:1770150260
Name:PEACE OF MIND COUNSELING CENTER, LLC
Entity type:Organization
Organization Name:PEACE OF MIND COUNSELING CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH CLINICIAN
Authorized Official - Prefix:MS
Authorized Official - First Name:KATRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:443-850-8589
Mailing Address - Street 1:17 WARREN RD STE 24A
Mailing Address - Street 2:
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-5012
Mailing Address - Country:US
Mailing Address - Phone:443-850-8589
Mailing Address - Fax:443-853-1213
Practice Address - Street 1:17 WARREN RD STE 24A
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-5012
Practice Address - Country:US
Practice Address - Phone:443-850-8589
Practice Address - Fax:443-853-1213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-04
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)