Healthcare Provider Details

I. General information

NPI: 1841106010
Provider Name (Legal Business Name): PEACE OF MIND 2.0 LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 DORA DR
CAHOKIA HEIGHTS IL
62206-2753
US

IV. Provider business mailing address

35 DORA DR
CAHOKIA HEIGHTS IL
62206-2753
US

V. Phone/Fax

Practice location:
  • Phone: 618-954-9399
  • Fax:
Mailing address:
  • Phone: 618-954-9399
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: CHIQUITA R SMITH
Title or Position: CEO
Credential: LCSW
Phone: 618-954-9399