Provider Demographics
NPI:1073390324
Name:BLUE MIND THERAPY & WELLNESS
Entity Type:Organization
Organization Name:BLUE MIND THERAPY & WELLNESS
Other - Org Name:CHERIE L COOPERSMITH
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHERIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:COOPERSMITH
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:989-239-5696
Mailing Address - Street 1:11255 MOORFIELD DR
Mailing Address - Street 2:
Mailing Address - City:FREELAND
Mailing Address - State:MI
Mailing Address - Zip Code:48623-7201
Mailing Address - Country:US
Mailing Address - Phone:989-239-5696
Mailing Address - Fax:
Practice Address - Street 1:120 N MICHIGAN AVE STE 212
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48602-4236
Practice Address - Country:US
Practice Address - Phone:989-239-5696
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-11
Last Update Date:2024-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty