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General NPI Number Information
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NPI Number | 1457387623
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Entity Type | Organization
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Legal Business Name | PEACE OF MIND COUNSELING, LTD.
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Dates
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Enumeration Date | 06/23/2006
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Last Update Date | 10/12/2007
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Provider Practice Location Address
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Address Line | 555 2ND AVE SUITE B-350
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City | COLLEGEVILLE
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State | PA
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Zip | 19426-3600
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Country | US
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Telephone | 215-703-3215
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Fax | 215-703-3217
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Provider Business Mailing Address
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Address Line | 555 2ND AVE SUITE B-350
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City | COLLEGEVILLE
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State | PA
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Zip | 19426-3600
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Country | US
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Telephone | 215-703-3215
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Fax | 215-703-3217
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | MS. SERENE R. BAILEY
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Credential | LPC, LMFT
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Telephone | 215-703-3215
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | PC003763
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License Number State | PA
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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 | 0701003315
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 0717001082
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MF000492
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License Number State | PA
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