Provider Demographics
NPI:1609596527
Name:SOUND MIND COUNSELING LCSW-R PC
Entity Type:Organization
Organization Name:SOUND MIND COUNSELING LCSW-R PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, LCSW-R
Authorized Official - Prefix:
Authorized Official - First Name:CLAUDINE
Authorized Official - Middle Name:
Authorized Official - Last Name:AIEVOLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-529-6871
Mailing Address - Street 1:1508 STEVENS AVE
Mailing Address - Street 2:
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-2237
Mailing Address - Country:US
Mailing Address - Phone:941-529-6871
Mailing Address - Fax:
Practice Address - Street 1:1508 STEVENS AVE
Practice Address - Street 2:
Practice Address - City:MERRICK
Practice Address - State:NY
Practice Address - Zip Code:11566-2237
Practice Address - Country:US
Practice Address - Phone:941-529-6871
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-31
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty