Provider Demographics
NPI:1770291858
Name:SOUND MIND COUNSELING LLC
Entity type:Organization
Organization Name:SOUND MIND COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LPC
Authorized Official - Prefix:
Authorized Official - First Name:SHANE
Authorized Official - Middle Name:G
Authorized Official - Last Name:LATHAM
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:815-353-1013
Mailing Address - Street 1:2685 PELHAM PKWY STE B
Mailing Address - Street 2:
Mailing Address - City:PELHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35124-1354
Mailing Address - Country:US
Mailing Address - Phone:815-353-1013
Mailing Address - Fax:
Practice Address - Street 1:2685 PELHAM PKWY STE B
Practice Address - Street 2:
Practice Address - City:PELHAM
Practice Address - State:AL
Practice Address - Zip Code:35124-1354
Practice Address - Country:US
Practice Address - Phone:815-353-1013
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-08
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)