MEDICARE: THE PEACEFUL MIND COUNSELING CENTER, 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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1811739337
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE PEACEFUL MIND COUNSELING CENTER, LLC

Provider Business Mailing Address
First Line	:	PO BOX 780461
Second Line	:
City	:	SEBASTIAN
State	:	FL
Zip	:	32978-0461
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1275 US HIGHWAY 1
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32960-5783
Country	:	US
Telephone Number	:	321-626-7122
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JEANNE LANO
Credential	:	LMHC
Telephone Number	:	321-626-7122

Provider Enumeration Date	:	06/07/2024
Last Update Date	:	06/07/2024

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