Mind Trust Counseling and Consulting Services,PC

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

License

6401012459 Issued in MI

Legal business name

MIND TRUST COUNSELING AND CONSULTING SERVICES,PC

Practice address

16250 Northland Dr Ste 115
Southfield, MI 48075-5221

Phone

(313) 595-3125

Fax

(313) 447-2277

NPI assigned

Jul 26, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Vanessa Lorraine Lewis, LLPC

Title

Chief Executive Officer

Phone

(313) 595-3125

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1406332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406332800000",
    "number": "1518375294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16250 NORTHLAND DR STE 115",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480755221",
            "telephone_number": "313-595-3125",
            "fax_number": "313-447-2277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16250 NORTHLAND DR STE 115",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480755221",
            "telephone_number": "313-595-3125",
            "fax_number": "313-447-2277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND TRUST COUNSELING AND CONSULTING SERVICES,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-26",
        "last_updated": "2014-07-26",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "VANESSA",
        "authorized_official_middle_name": "LORRAINE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "313-595-3125",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LLPC"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "MI",
            "license": "6401012459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Terri L Miller, RN
• Armeria Millhouse
• Laquita Mims
• Mind Management Institute Inc
• Mind Spa, LLC
• Mindful Clarity LLC
• Mindful Concepts, LLC
• Mindful Serenity Solutions, LLC
• Mindharbor Therapy PC
• Mindkraft Solutions LLC

• Exclusive Provider Organization in Southfield, MI
• Providers in Southfield, MI by specialty
• Exclusive Provider Organization in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.