MEDICARE: PEACE OF MIND COUNSELING SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	NONE	OTHER	IN	NONE

General Provider Information

NPI Number	:	1508460775
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEACE OF MIND COUNSELING SERVICES LLC

Provider Business Mailing Address
First Line	:	941 E 86TH ST STE 112
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46240-1842
Country	:	US
Telephone Number	:	317-292-9702
Fax Number	:	317-426-6809

Provider Business Practice Location Address
First Line	:	941 E 86TH ST STE 112
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46240-1842
Country	:	US
Telephone Number	:	317-292-9702
Fax Number	:	317-426-6809

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MICHAEL TREXLER
Credential	:	PHD, LMHC, NCC
Telephone Number	:	317-292-9702

Provider Enumeration Date	:	11/28/2020
Last Update Date	:	06/20/2023

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