Organization Active NPI

Peace of Mind Counseling, LLC

  • Community/Behavioral Health Agency
  • Maryville, IL
National Provider Identifier
1669858536
Registry record updated Mar 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
149.013539 Issued in IL
Legal business name
PEACE OF MIND COUNSELING, LLC
Practice address
2016 Vadalabene Dr Ste a
Maryville, IL 62062-6901
Phone
(618) 823-6444
Fax
(618) 551-8456
NPI assigned
Aug 3, 2015
Last updated
Mar 8, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2016

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

Authorized official

Name
Diane Bracamontes, LCSWNPI 1306089974
Title
Owner
Phone
(618) 823-6444

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 149.013539 IL Primary

Addresses

Primary practice location

2016 Vadalabene Dr Ste a
Maryville, IL 62062-6901

Mailing address

2016 Vadalabene Dr Ste a
Maryville, IL 62062-6901
Phone (618) 823-6444

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1438560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457395200000",
    "number": "1669858536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2016 VADALABENE DR STE A",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620626901",
            "telephone_number": "618-823-6444",
            "fax_number": "618-551-8456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2016 VADALABENE DR STE A",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620626901",
            "telephone_number": "618-823-6444",
            "fax_number": "618-551-8456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACE OF MIND COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-03",
        "last_updated": "2016-03-08",
        "status": "A",
        "authorized_official_last_name": "BRACAMONTES",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-823-6444",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IL",
            "license": "149.013539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2016; 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.