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General NPI Number Information
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NPI Number | 1386322915
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Entity Type | Organization
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Legal Business Name | SOUND MIND COUNSELING CENTER, LLC
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Dates
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Enumeration Date | 07/05/2023
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Last Update Date | 07/05/2023
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Provider Practice Location Address
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Address Line | 1202 JONATHAN LN
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City | MARLTON
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State | NJ
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Zip | 08053-4520
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Country | US
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Telephone | 856-452-1021
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Fax |
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Provider Business Mailing Address
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Address Line | 532 OLD MARLTON PIKE W #524
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City | MARLTON
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State | NJ
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Zip | 08053
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Country | US
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Telephone | 856-452-1021
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Fax |
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Authorized Official
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Title or Position | CEO & MENTAL HEALTH THERAPIST
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Name | MRS. SELENA FISHER
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Credential | LPC
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Telephone | 856-452-1021
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #3
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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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