Healthcare Provider Details

I. General information

NPI: 1740987122
Provider Name (Legal Business Name): MIND IS UNIQUE COUNSELING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2023
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1025 WARRENTON HWY STE A
THOMSON GA
30824-8061
US

IV. Provider business mailing address

368 NORWOOD CAMAK RD
NORWOOD GA
30821-5919
US

V. Phone/Fax

Practice location:
  • Phone: 478-456-5863
  • Fax:
Mailing address:
  • Phone: 478-456-5863
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: SHEANETTE S DRAKE
Title or Position: OWNER
Credential: LCSW
Phone: 478-456-5863