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General NPI Number Information
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NPI Number | 1669239596
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Entity Type | Organization
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Legal Business Name | PEACE OF MIND CHRISTIAN COUNSELING, LLC
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Dates
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Enumeration Date | 03/06/2024
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Last Update Date | 03/06/2024
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Provider Practice Location Address
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Address Line | 29777 TELEGRAPH RD., #1350
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City | SOUTHFIELD
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State | MI
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Zip | 48034
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Country | US
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Telephone | 240-923-0053
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Fax | 240-368-5375
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Provider Business Mailing Address
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Address Line | 15900 W. 10 MILE RD STE. 211 #424
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City | SOUTHFIELD
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State | MI
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Zip | 48075
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Country | US
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Telephone | 240-923-0053
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Fax | 240-368-5375
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Authorized Official
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Title or Position | OWNER
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Name | MARKIETA JOYCE BOSWELL
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Credential | MA, LPC
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Telephone | 248-210-8380
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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 |
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License Number State |
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