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General NPI Number Information
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NPI Number | 1790352490
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Entity Type | Organization
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Legal Business Name | MASTERMINDS CLINICAL COUNSELING & CONSULTING FIRM LLC
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Dates
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Enumeration Date | 06/10/2021
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Last Update Date | 06/17/2021
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Provider Practice Location Address
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Address Line | 880 MANDALAY AVE APT N702
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City | CLEARWATER
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State | FL
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Zip | 33767-1227
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Country | US
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Telephone | 301-573-4681
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Fax |
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Provider Business Mailing Address
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Address Line | 880 MANDALAY AVE APT N702
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City | CLEARWATER
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State | FL
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Zip | 33767-1227
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Country | US
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Telephone | 301-573-4681
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Fax |
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Authorized Official
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Title or Position | OWNER/CLINICIAN
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Name | MS. COURTNEY RENEE LLOYD
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Credential | LCSW-C, LCSW
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Telephone | 301-573-4681
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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