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General NPI Number Information
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NPI Number | 1104710532
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Entity Type | Organization
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Legal Business Name | UNLEASHED MIND COUNSELING SERVICES
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Dates
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Enumeration Date | 06/09/2025
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Last Update Date | 06/09/2025
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Provider Practice Location Address
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Address Line | 300 S HAMILTON AVE
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City | GREENSBURG
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State | PA
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Zip | 15601-7925
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Country | US
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Telephone | 724-221-7621
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Fax |
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Provider Business Mailing Address
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Address Line | 369 NARROWS RD
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City | CONNELLSVILLE
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State | PA
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Zip | 15425-6139
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Country | US
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Telephone | 724-221-7621
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TYLER FOX
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Credential | LPC
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Telephone | 724-221-7621
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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