Provider Demographics
NPI:1164194346
Name:MIND OF PEACE COUNSELING
Entity Type:Organization
Organization Name:MIND OF PEACE COUNSELING
Other - Org Name:MIND OF PEACE COUNSELING LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LYNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:BELKNAP-WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:308-631-6066
Mailing Address - Street 1:688 ANTELOPE GAP RD
Mailing Address - Street 2:
Mailing Address - City:WHEATLAND
Mailing Address - State:WY
Mailing Address - Zip Code:82201-8810
Mailing Address - Country:US
Mailing Address - Phone:307-631-6066
Mailing Address - Fax:
Practice Address - Street 1:145 S DURBIN ST
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-2538
Practice Address - Country:US
Practice Address - Phone:308-631-6066
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-05
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty