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General NPI Number Information
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NPI Number | 1992343388
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Entity Type | Organization
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Legal Business Name | PEACE OF MIND COUNSELING, LLC
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Dates
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Enumeration Date | 12/16/2019
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Last Update Date | 12/16/2019
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Provider Practice Location Address
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Address Line | 3349 RIDGELAKE DR.
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City | METAIRIE
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State | LA
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Zip | 70002-3851
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Country | US
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Telephone | 504-439-1969
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Fax | 504-666-3938
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Provider Business Mailing Address
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Address Line | 5713 MARCIE ST
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City | METAIRIE
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State | LA
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Zip | 70003-1909
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Country | US
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Telephone | 504-439-1969
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Fax | 504-666-3938
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Authorized Official
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Title or Position | OWNER/THERPIST
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Name | MICHELLE MARIE WAGHORNE
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Credential | LCSW
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Telephone | 504-439-1969
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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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