Provider Demographics
NPI:1295187425
Name:MIND MATTERS COACHING, COUNSELING, & PSYCHOLOGICAL ASSOCIATES LLC
Entity Type:Organization
Organization Name:MIND MATTERS COACHING, COUNSELING, & PSYCHOLOGICAL ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:MAE
Authorized Official - Last Name:CHAUNDY
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:610-301-8360
Mailing Address - Street 1:2208 QUARRY DR
Mailing Address - Street 2:VAN REED OFFICE CENTER, SUITE #200
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19609-1158
Mailing Address - Country:US
Mailing Address - Phone:610-563-2052
Mailing Address - Fax:
Practice Address - Street 1:2209 QUARRY DR STE A10
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19609-1153
Practice Address - Country:US
Practice Address - Phone:844-696-4631
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-12
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS018003103T00000X
PACW0160691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty