Provider Demographics
NPI:1255839528
Name:BEAUTIFUL MINDS, THERAPY AND CONSULTATION
Entity Type:Organization
Organization Name:BEAUTIFUL MINDS, THERAPY AND CONSULTATION
Other - Org Name:BEAUTIFUL MINDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/DIRECTOR OF CLINICAL SERVICES
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:COX
Authorized Official - Suffix:JR
Authorized Official - Credentials:LPC, LCADC, ACS
Authorized Official - Phone:609-365-0712
Mailing Address - Street 1:305 INDEPENDENCE BLVD
Mailing Address - Street 2:
Mailing Address - City:SICKLERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08081-1093
Mailing Address - Country:US
Mailing Address - Phone:609-350-5007
Mailing Address - Fax:609-904-2265
Practice Address - Street 1:305 INDEPENDENCE BLVD
Practice Address - Street 2:
Practice Address - City:SICKLERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08081-1093
Practice Address - Country:US
Practice Address - Phone:609-350-5007
Practice Address - Fax:609-904-2265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-31
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health