Healthcare Provider Details

I. General information

NPI: 1386552388
Provider Name (Legal Business Name): PEACEFUL MIND COUNSELING AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

318 MADISON ST
PORT CLINTON OH
43452-1921
US

IV. Provider business mailing address

318 MADISON ST
PORT CLINTON OH
43452-1921
US

V. Phone/Fax

Practice location:
  • Phone: 419-504-0074
  • Fax: 419-734-2123
Mailing address:
  • Phone: 419-504-0074
  • Fax: 419-734-2123

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: HEATHER MCCOOL
Title or Position: OWNER/THERAPIST
Credential: LISWS
Phone: 419-504-0074