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General NPI Number Information
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NPI Number | 1053996231
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Entity Type | Organization
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Legal Business Name | PEACE OF MIND MENTAL HEALTH SERVICES LLC
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Dates
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Enumeration Date | 03/10/2021
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Last Update Date | 08/04/2025
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Provider Practice Location Address
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Address Line | 4410 E CLAIBORNE SQUARE SUITE 334
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City | HAMPTON
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State | VA
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Zip | 23666
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Country | US
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Telephone | 757-960-3121
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Fax | 757-665-2962
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Provider Business Mailing Address
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Address Line | 4410 E CLAIBORNE SQUARE SUITE 334
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City | HAMPTON
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State | VA
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Zip | 23666
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Country | US
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Telephone | 757-960-3121
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Fax | 757-665-2962
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Authorized Official
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Title or Position | CEO
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Name | KRYSTAL THOMPSON
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Credential | LPC
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Telephone | 757-960-3121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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