Healthcare Provider Details
I. General information
NPI: 1053996231
Provider Name (Legal Business Name): PEACE OF MIND MENTAL HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/10/2021
Last Update Date: 08/04/2025
Certification Date: 01/14/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4410 E CLAIBORNE SQUARE SUITE 334
HAMPTON VA
23666
US
IV. Provider business mailing address
4410 E CLAIBORNE SQUARE SUITE 334
HAMPTON VA
23666
US
V. Phone/Fax
- Phone: 757-960-3121
- Fax: 757-665-2962
- Phone: 757-960-3121
- Fax: 757-665-2962
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101Y00000X |
| Taxonomy | Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KRYSTAL
THOMPSON
Title or Position: CEO
Credential: LPC
Phone: 757-960-3121