Provider Demographics
NPI:1417544644
Name:AWAKENED MIND COUNSELING CENTER LLC
Entity Type:Organization
Organization Name:AWAKENED MIND COUNSELING CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/COUNSELOR
Authorized Official - Prefix:MR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:
Authorized Official - Last Name:HIRSCH
Authorized Official - Suffix:JR
Authorized Official - Credentials:LPC
Authorized Official - Phone:717-630-3140
Mailing Address - Street 1:62 COLLINS CIR
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-3448
Mailing Address - Country:US
Mailing Address - Phone:717-630-3140
Mailing Address - Fax:
Practice Address - Street 1:62 COLLINS CIR
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-3448
Practice Address - Country:US
Practice Address - Phone:717-630-3140
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-22
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)