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General NPI Number Information
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NPI Number | 1376263913
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Entity Type | Organization
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Legal Business Name | PEACE OF MIND CLINICAL AND CONSULTING SERVICES INC.
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Dates
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Enumeration Date | 09/01/2022
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Last Update Date | 09/01/2022
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Provider Practice Location Address
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Address Line | 8825 153RD ST APT 2P
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City | JAMAICA
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State | NY
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Zip | 11432-3752
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Country | US
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Telephone | 347-674-1520
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Fax |
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Provider Business Mailing Address
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Address Line | 8825 153RD ST APT 2P
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City | JAMAICA
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State | NY
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Zip | 11432-3752
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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 | RACQUEL ELLIS
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Credential | LMHC
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Telephone | 347-416-2575
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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 |
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License Number State |
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