Provider Demographics
NPI:1003523622
Name:PEACEFUL MIND COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:PEACEFUL MIND COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:VIVIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ARROYO
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LSW, LCADC
Authorized Official - Phone:973-289-1820
Mailing Address - Street 1:76 BALDWIN PL
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-6011
Mailing Address - Country:US
Mailing Address - Phone:973-289-1820
Mailing Address - Fax:
Practice Address - Street 1:76 BALDWIN PL
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07003-6011
Practice Address - Country:US
Practice Address - Phone:973-289-1820
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-02
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1760993224OtherPRIVATE