Provider Demographics
NPI:1568913960
Name:SPIRIT-MIND-BODY CONNECTIONS COUNSELING, PLLC
Entity Type:Organization
Organization Name:SPIRIT-MIND-BODY CONNECTIONS COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED AGENT
Authorized Official - Prefix:
Authorized Official - First Name:NOEMI
Authorized Official - Middle Name:
Authorized Official - Last Name:MENDEZ-HYAMS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:469-701-0572
Mailing Address - Street 1:PO BOX 709
Mailing Address - Street 2:
Mailing Address - City:WYLIE
Mailing Address - State:TX
Mailing Address - Zip Code:75098-0709
Mailing Address - Country:US
Mailing Address - Phone:469-701-0572
Mailing Address - Fax:
Practice Address - Street 1:311 N BALLARD AVE STE 102
Practice Address - Street 2:
Practice Address - City:WYLIE
Practice Address - State:TX
Practice Address - Zip Code:75098-4486
Practice Address - Country:US
Practice Address - Phone:469-701-0572
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-20
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64318101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty