Provider Demographics
NPI:1346946480
Name:PEACE OF MIND MENTAL HEALTH SERVICES PLLC
Entity Type:Organization
Organization Name:PEACE OF MIND MENTAL HEALTH SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MATTERN
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:203-654-6915
Mailing Address - Street 1:170 MUNGERTOWN RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:CT
Mailing Address - Zip Code:06443-2259
Mailing Address - Country:US
Mailing Address - Phone:203-654-6915
Mailing Address - Fax:
Practice Address - Street 1:116 MONTOWESE ST
Practice Address - Street 2:
Practice Address - City:BRANFORD
Practice Address - State:CT
Practice Address - Zip Code:06405-3871
Practice Address - Country:US
Practice Address - Phone:203-654-6915
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-31
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty