Provider Demographics
NPI:1477213353
Name:PEACE OF MIND PSYCHOLOGICAL SERVICES, PLLC
Entity Type:Organization
Organization Name:PEACE OF MIND PSYCHOLOGICAL SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LEAD CLINICIAN/LPA
Authorized Official - Prefix:MR
Authorized Official - First Name:WARREN
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:HOSKINS
Authorized Official - Suffix:II
Authorized Official - Credentials:LPA-HSP,MA
Authorized Official - Phone:704-369-1771
Mailing Address - Street 1:3379 TARLETON W
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-5404
Mailing Address - Country:US
Mailing Address - Phone:704-369-1771
Mailing Address - Fax:
Practice Address - Street 1:2530 MERIDIAN PKWY # 3129
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-5272
Practice Address - Country:US
Practice Address - Phone:984-400-4823
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-20
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty