Provider Demographics
NPI:1942065768
Name:MIND MEADOW COUNSELING LLC
Entity type:Organization
Organization Name:MIND MEADOW COUNSELING LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ZACKARY
Authorized Official - Middle Name:
Authorized Official - Last Name:ALJURIDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-945-9224
Mailing Address - Street 1:10560 MAIN ST STE 611
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-7114
Mailing Address - Country:US
Mailing Address - Phone:703-972-2120
Mailing Address - Fax:949-695-4194
Practice Address - Street 1:10560 MAIN ST STE 611
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-7114
Practice Address - Country:US
Practice Address - Phone:703-972-2120
Practice Address - Fax:949-695-4194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-20
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty