Healthcare Provider Details

I. General information

NPI: 1346571478
Provider Name (Legal Business Name): PEACE OF MIND COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2010
Last Update Date: 01/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5326 W BELLFORT ST STE 110
HOUSTON TX
77035-3031
US

IV. Provider business mailing address

PO BOX 376
FRESNO TX
77545-0376
US

V. Phone/Fax

Practice location:
  • Phone: 281-788-7975
  • Fax: 281-466-4430
Mailing address:
  • Phone: 281-788-7975
  • Fax: 281-466-4430

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number19315
License Number StateTX

VIII. Authorized Official

Name: DR. MELISSA K EARLS
Title or Position: EXECUTIVE DIRECTOR
Credential: ED. D., L. P. C.
Phone: 281-788-7975