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General NPI Number Information
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NPI Number | 1295280253
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Entity Type | Organization
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Legal Business Name | HEALTHY MIND COUNSELING PLLC
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Dates
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Enumeration Date | 08/19/2016
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Last Update Date | 09/30/2021
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Provider Practice Location Address
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Address Line | 6995 W 48TH ST
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City | FREMONT
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State | MI
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Zip | 49412-9506
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Country | US
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Telephone | 231-335-1718
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Fax | 231-422-0022
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Provider Business Mailing Address
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Address Line | 6995 W 48TH ST
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City | FREMONT
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State | MI
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Zip | 49412-9506
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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 | OWNER
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Name | SALENA PHILLIPS-BAKER
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Credential |
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Telephone | 231-335-1718
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 6401012362
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License Number State | MI
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Taxonomy #2
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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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