Peace of Mind Therapy, PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801093391 Issued in MI

Legal business name

PEACE OF MIND THERAPY, PLLC

Practice address

2615 W 12 Mile Rd Ste 119
Berkley, MI 48072-1627

Phone

(248) 397-4705

NPI assigned

Mar 20, 2018

Organization subpart

No

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

Authorized official

Name

Lauren Lucielle Provencher, LMSW

Title

Owner/Clinical Therapist

Phone

(248) 397-4705

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ronit Weinmann

  • Clinical Social Worker
  • Berkley, MI
  • NPI 1366815565
  NPD (past)

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

{
    "created_epoch": "1521504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525478400000",
    "number": "1730683368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2615 W 12 MILE RD STE 119",
            "city": "BERKLEY",
            "state": "MI",
            "postal_code": "480721627",
            "telephone_number": "248-397-4705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2615 W 12 MILE RD STE 119",
            "city": "BERKLEY",
            "state": "MI",
            "postal_code": "480721627",
            "telephone_number": "248-397-4705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACE OF MIND THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-20",
        "last_updated": "2018-05-05",
        "status": "A",
        "authorized_official_last_name": "PROVENCHER",
        "authorized_official_first_name": "LAUREN",
        "authorized_official_middle_name": "LUCIELLE",
        "authorized_official_title_or_position": "OWNER/CLINICAL THERAPIST",
        "authorized_official_telephone_number": "248-397-4705",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801093391",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS/BCN",
            "identifier": "1285918631",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dorothy Pasikowski, D.D.S.
• Pari Patel
• Paul Benson DO PC
• Alex S Paul
• Sander J Paul, M.D.
• Perry Drug Stores Inc and Subsidiaries
• Judy Perry, RDH
• Christopher David Petrat
• Judith Ann Petrella, CTRS
• Lisa Marie Phillips, BS

• Clinical Social Worker in Berkley, MI
• Providers in Berkley, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2018; 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.