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General NPI Number Information
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NPI Number | 1255012423
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Entity Type | Organization
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Legal Business Name | INTUIMIND INDIVIDUAL AND COUPLES COUNSELING INC.
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Dates
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Enumeration Date | 07/31/2023
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Last Update Date | 07/31/2023
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Provider Practice Location Address
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Address Line | 414 S MAIN ST
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City | LAKEPORT
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State | CA
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Zip | 95453-5316
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Country | US
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Telephone | 562-326-1382
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Fax |
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Provider Business Mailing Address
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Address Line | 9734 STATE HIGHWAY 281 # 5080
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City | KELSEYVILLE
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State | CA
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Zip | 95451-8401
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Country | US
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Telephone | 877-921-4119
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Fax |
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | MRS. LEE ZELEDON
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Credential | LMFT
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Telephone | 562-326-1382
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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