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General NPI Number Information
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NPI Number | 1922756022
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Entity Type | Organization
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Legal Business Name | ZENMIND THERAPY, LLC
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Dates
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Enumeration Date | 03/17/2022
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Last Update Date | 03/17/2022
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Provider Practice Location Address
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Address Line | 6609 BLANCO ROAD SUITE 300
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City | SAN ANTONIO
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State | TX
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Zip | 78216
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Country | US
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Telephone | 571-544-9444
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Fax |
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Provider Business Mailing Address
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Address Line | 3601 PICKETT RD UNIT 2272
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City | FAIRFAX
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State | VA
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Zip | 22031-8114
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Country | US
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Telephone | 202-415-6556
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ROSE-MARIE D PHILLIPS
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Credential |
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Telephone | 202-415-6556
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 102L00000X
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Taxonomy Name | Psychoanalyst
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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 | 261QM1300X
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Taxonomy Name | Multi-Specialty 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 | 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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