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General NPI Number Information
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NPI Number | 1285330464
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Entity Type | Organization
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Legal Business Name | MIND OVER MATTER COUNSELING LLC
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Dates
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Enumeration Date | 01/31/2023
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Last Update Date | 01/31/2023
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Provider Practice Location Address
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Address Line | 1816 S MAGNOLIA DR
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City | TALLAHASSEE
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State | FL
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Zip | 32301-5757
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Country | US
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Telephone | 850-459-3546
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Fax |
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Provider Business Mailing Address
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Address Line | 1816 S MAGNOLIA DR
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City | TALLAHASSEE
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State | FL
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Zip | 32301-5757
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Country | US
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Telephone | 850-459-3546
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Fax |
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Authorized Official
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Title or Position | LICENSED MENTAL HEALTH COUNSELOR
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Name | ALICIA JONES
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Credential | LMHC
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Telephone | 850-739-0273
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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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