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General NPI Number Information
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NPI Number | 1861357212
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Entity Type | Organization
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Legal Business Name | A PLACE OF MIND LLC
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Dates
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Enumeration Date | 12/18/2025
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Last Update Date | 12/18/2025
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Provider Practice Location Address
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Address Line | 66077 W 8 MILE RD
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City | SOUTH LYON
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State | MI
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Zip | 48178-7074
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Country | US
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Telephone | 989-906-1006
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Fax |
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Provider Business Mailing Address
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Address Line | 66077 W 8 MILE RD
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City | SOUTH LYON
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State | MI
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Zip | 48178-7074
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Country | US
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Telephone | 989-906-1006
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | ADRIANNA M PENA-VAN DEN BOSSCHE
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Credential | M.S., LLPC
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Telephone | 248-264-2522
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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