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General NPI Number Information
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NPI Number | 1174206650
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Entity Type | Organization
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Legal Business Name | MASTER YOUR MIND COUNSELING AND CONSULTATION, LLC
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Dates
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Enumeration Date | 08/10/2023
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Last Update Date | 08/10/2023
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Provider Practice Location Address
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Address Line | 3391 HELENE RIEDER DR
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City | MONTGOMERY
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State | IL
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Zip | 60538-6025
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Country | US
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Telephone | 630-418-8918
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Fax |
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Provider Business Mailing Address
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Address Line | 1552 S ROUTE 59 # 1387
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City | NAPERVILLE
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State | IL
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Zip | 60564-5941
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Country | US
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Telephone | 630-418-8918
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Fax |
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Authorized Official
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Title or Position | CO-OWNER/THERAPIST
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Name | DR. THERRON ROGERS
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Credential | PHD, LCPC
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Telephone | 859-227-7189
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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