Provider Demographics
NPI:1629756861
Name:MIND ELEVATION COUNSELING AND COACHING, LLC
Entity Type:Organization
Organization Name:MIND ELEVATION COUNSELING AND COACHING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LSW/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NIA'
Authorized Official - Middle Name:
Authorized Official - Last Name:BRIGHTWELL
Authorized Official - Suffix:
Authorized Official - Credentials:LSW
Authorized Official - Phone:812-584-9439
Mailing Address - Street 1:#1039 7800 MONTGOMERY RD
Mailing Address - Street 2:UNIT 200
Mailing Address - City:KENWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:45236
Mailing Address - Country:US
Mailing Address - Phone:812-584-9439
Mailing Address - Fax:
Practice Address - Street 1:1172 W GALBRAITH RD STE 212
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45231-5643
Practice Address - Country:US
Practice Address - Phone:812-584-9439
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-07
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty