Provider Demographics
NPI:1538637293
Name:MINDSET COUNSELING SOLUTIONS
Entity Type:Organization
Organization Name:MINDSET COUNSELING SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:C
Authorized Official - Last Name:MATTICK
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMHC, CAP
Authorized Official - Phone:772-475-6545
Mailing Address - Street 1:3270 SUNTREE BLVD STE 102C
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-7544
Mailing Address - Country:US
Mailing Address - Phone:321-593-0759
Mailing Address - Fax:
Practice Address - Street 1:3270 SUNTREE BLVD STE 102C
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-7544
Practice Address - Country:US
Practice Address - Phone:321-593-0759
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-10
Last Update Date:2018-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty