Provider Demographics
NPI:1467090027
Name:HEART SOUL MIND STRENGTH LLC
Entity Type:Organization
Organization Name:HEART SOUL MIND STRENGTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:POWERS
Authorized Official - Suffix:
Authorized Official - Credentials:MA LPC CAADC ADS MIT
Authorized Official - Phone:510-827-1305
Mailing Address - Street 1:3628 LANCASTER DRIVE
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49006
Mailing Address - Country:US
Mailing Address - Phone:269-352-6639
Mailing Address - Fax:
Practice Address - Street 1:200 TURWILL LN STE 1
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49006-4277
Practice Address - Country:US
Practice Address - Phone:510-827-1305
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-13
Last Update Date:2019-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty