Provider Demographics
NPI:1639879786
Name:PEACE OF MIND PSYCHOTHERAPY SERVICES LLC
Entity Type:Organization
Organization Name:PEACE OF MIND PSYCHOTHERAPY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:OWEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LCP
Authorized Official - Phone:540-577-5847
Mailing Address - Street 1:PO BOX 345
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24068-0345
Mailing Address - Country:US
Mailing Address - Phone:540-577-5847
Mailing Address - Fax:
Practice Address - Street 1:260 MEADOW DR
Practice Address - Street 2:
Practice Address - City:CHRISTIANSBURG
Practice Address - State:VA
Practice Address - Zip Code:24073-1168
Practice Address - Country:US
Practice Address - Phone:540-577-5847
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-07
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health