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General NPI Number Information
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NPI Number | 1770163164
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Entity Type | Organization
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Legal Business Name | FREE YOUR MIND COUNSELING, INC.
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Dates
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Enumeration Date | 04/10/2021
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Last Update Date | 04/10/2021
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Provider Practice Location Address
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Address Line | 22791 JUNEBERRY CT
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City | ELKHART
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State | IN
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Zip | 46514-9152
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Country | US
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Telephone | 574-400-5158
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Fax | 574-701-2700
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Provider Business Mailing Address
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Address Line | 22791 JUNEBERRY CT
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City | ELKHART
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State | IN
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Zip | 46514-9152
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Country | US
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Telephone | 574-400-5158
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Fax | 574-701-2700
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Authorized Official
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Title or Position | OWNER, PRESIDENT, CEO
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Name | MRS. ANGELA PATRICIA GARCIA
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Credential | LMHC, NCC, M.ED.
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Telephone | 574-400-5158
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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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 | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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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 | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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