Healthcare Provider Details

I. General information

NPI: 1831056829
Provider Name (Legal Business Name): MULTIFACETED MINDSET
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2026
Last Update Date: 01/09/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

885 GOLD HILL RD
FORT MILL SC
29708-7946
US

IV. Provider business mailing address

885 GOLD HILL RD
FORT MILL SC
29708-7946
US

V. Phone/Fax

Practice location:
  • Phone: 678-383-7807
  • Fax:
Mailing address:
  • Phone: 678-383-7807
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: MRS. BRIANA MACK
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: LPC, LCMHC
Phone: 678-383-7807