Provider Demographics
NPI:1114607199
Name:MIND REFRESH COUNSELING CENTER LLC
Entity Type:Organization
Organization Name:MIND REFRESH COUNSELING CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:T
Authorized Official - Last Name:BOND
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:248-658-8424
Mailing Address - Street 1:801 W BIG BEAVER RD STE 300
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-4725
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:801 W BIG BEAVER RD
Practice Address - Street 2:SUITE 300
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-2801
Practice Address - Country:US
Practice Address - Phone:248-658-8424
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-24
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty