Provider Demographics
NPI:1356859565
Name:PEACE OF MIND THERAPY, INC.
Entity Type:Organization
Organization Name:PEACE OF MIND THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LIMOR
Authorized Official - Middle Name:
Authorized Official - Last Name:GRINBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-509-0064
Mailing Address - Street 1:18800 NE 29TH AVE APT PH13
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-2822
Mailing Address - Country:US
Mailing Address - Phone:305-509-0064
Mailing Address - Fax:
Practice Address - Street 1:1001 N FEDERAL HWY STE 327
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-2425
Practice Address - Country:US
Practice Address - Phone:305-509-0064
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-22
Last Update Date:2018-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW140721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty