Provider Demographics
NPI:1134699317
Name:JUST BREATHE COUNSELING
Entity Type:Organization
Organization Name:JUST BREATHE COUNSELING
Other - Org Name:JUST BREATHE COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:UNDERWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:219-545-2972
Mailing Address - Street 1:517 FRANKLIN ST # 104
Mailing Address - Street 2:
Mailing Address - City:MICHIGAN CITY
Mailing Address - State:IN
Mailing Address - Zip Code:46360-3328
Mailing Address - Country:US
Mailing Address - Phone:219-545-2972
Mailing Address - Fax:219-728-1485
Practice Address - Street 1:517 FRANKLIN ST # 104
Practice Address - Street 2:
Practice Address - City:MICHIGAN CITY
Practice Address - State:IN
Practice Address - Zip Code:46360
Practice Address - Country:US
Practice Address - Phone:219-545-2972
Practice Address - Fax:219-728-1485
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-29
Last Update Date:2019-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN39002765AOtherINDIANA PROFESSIONAL LICENSING AGENCY