Healthcare Provider Details

I. General information

NPI: 1881969707
Provider Name (Legal Business Name): PEASE OF MIND SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2012
Last Update Date: 06/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2695 SLOPE HILL RD
MT PLEASANT PA
15666-8975
US

IV. Provider business mailing address

2695 SLOPE HILL RD
MT PLEASANT PA
15666-8975
US

V. Phone/Fax

Practice location:
  • Phone: 724-220-2400
  • Fax:
Mailing address:
  • Phone: 724-220-2400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number
License Number StatePA
# 5
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberPN258043L
License Number StatePA
# 6
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name: MRS. DESIREE PEASE
Title or Position: EXECUTIVE DIRECTOR
Credential: LPN, AAC II,MSP,BSN
Phone: 724-220-2400