Healthcare Provider Details

I. General information

NPI: 1750780193
Provider Name (Legal Business Name): PEACE OF MIND THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2014
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6502 GRAND TETON PLZ STE 204
MADISON WI
53719-1047
US

IV. Provider business mailing address

6502 GRAND TETON PLZ STE 204
MADISON WI
53719-1047
US

V. Phone/Fax

Practice location:
  • Phone: 608-338-1786
  • Fax: 608-831-4383
Mailing address:
  • Phone: 608-338-1786
  • Fax: 608-831-4383

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number940-124
License Number StateWI

VIII. Authorized Official

Name: SARA TRIPALIN
Title or Position: OWNER
Credential: MS, LMFT
Phone: 608-338-1786