Provider Demographics
NPI:1114550035
Name:MINDFUL RESULTS COUNSELING CENTER
Entity Type:Organization
Organization Name:MINDFUL RESULTS COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:BOYES
Authorized Official - Suffix:
Authorized Official - Credentials:PHD LPC
Authorized Official - Phone:248-716-3770
Mailing Address - Street 1:31275 NORTHWESTERN HWY STE 150
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-2584
Mailing Address - Country:US
Mailing Address - Phone:248-716-3770
Mailing Address - Fax:
Practice Address - Street 1:31275 NORTHWESTERN HWY STE 150
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-2584
Practice Address - Country:US
Practice Address - Phone:248-716-3770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-19
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty