Provider Demographics
NPI:1245803212
Name:THE MIND SPOT, LLC
Entity Type:Organization
Organization Name:THE MIND SPOT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:
Authorized Official - Last Name:NOTEBOOM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-301-9802
Mailing Address - Street 1:3000 WESLAYAN ST STE 140
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-5700
Mailing Address - Country:US
Mailing Address - Phone:713-804-9560
Mailing Address - Fax:
Practice Address - Street 1:3000 WESLAYAN ST STE 140
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-5700
Practice Address - Country:US
Practice Address - Phone:713-804-9560
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-19
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty