Provider Demographics
NPI:1275217275
Name:MINDSTRONG PLLC
Entity Type:Organization
Organization Name:MINDSTRONG PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:ASHLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:POWELL
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHC
Authorized Official - Phone:678-372-3598
Mailing Address - Street 1:222 GLENWOOD AVE APT 205
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27603-1480
Mailing Address - Country:US
Mailing Address - Phone:678-372-3598
Mailing Address - Fax:
Practice Address - Street 1:222 GLENWOOD AVE APT 205
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27603-1480
Practice Address - Country:US
Practice Address - Phone:678-372-3598
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1285304865OtherNPI (INDIVIDUAL)