Provider Demographics
NPI:1275168239
Name:SOUND MIND COUNSELING LLC
Entity Type:Organization
Organization Name:SOUND MIND COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCPC
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:ARZAVALA-REED
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:618-698-3401
Mailing Address - Street 1:405 PIERCE BLVD
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:IL
Mailing Address - Zip Code:62269-2561
Mailing Address - Country:US
Mailing Address - Phone:618-698-3401
Mailing Address - Fax:
Practice Address - Street 1:8 1/2 CANTY LN
Practice Address - Street 2:
Practice Address - City:FAIRVIEW HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:62208-2624
Practice Address - Country:US
Practice Address - Phone:618-698-3401
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-10
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty