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General NPI Number Information
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NPI Number | 1164101671
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Entity Type | Organization
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Legal Business Name | HEART AND MIND HEALING THERAPEUTIC SERVICES LLC
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Dates
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Enumeration Date | 07/12/2023
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Last Update Date | 02/22/2024
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Provider Practice Location Address
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Address Line | 7250 NATALIE DR
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City | YPSILANTI
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State | MI
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Zip | 48197-6043
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Country | US
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Telephone | 734-756-3548
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 10
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City | MASON
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State | MI
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Zip | 48854-0010
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO/THERAPIST
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Name | KEVYN ANTHONY MONIER
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Credential | MSW LMSW
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Telephone | 734-756-3548
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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