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General NPI Number Information
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NPI Number | 1427970441
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Entity Type | Organization
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Legal Business Name | MIRRORS INC
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Dates
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Enumeration Date | 07/29/2026
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Last Update Date | 07/29/2026
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Provider Practice Location Address
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Address Line | 901 W JEFFERSON ST
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City | SPRINGFIELD
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State | IL
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Zip | 62702-4833
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Country | US
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Telephone | 217-801-8639
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Fax |
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Provider Business Mailing Address
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Address Line | 901 W JEFFERSON ST # PO423
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City | SPRINGFIELD
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State | IL
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Zip | 62702-4833
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Country | US
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Telephone | 217-801-8639
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MRS. DESHUN R MIMS
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Credential | ETC.
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Telephone | 217-801-8639
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101200000X
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Taxonomy Name | Drama Therapist
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) 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 | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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