Provider Demographics
NPI:1790154425
Name:SOUNDMIND A COUNSELING & WELLNESS CENTER
Entity Type:Organization
Organization Name:SOUNDMIND A COUNSELING & WELLNESS CENTER
Other - Org Name:SOUNDMIND ACWC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-238-6400
Mailing Address - Street 1:30520 RANCHO CALIFORNIA RD
Mailing Address - Street 2:STE.10783
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92591-3212
Mailing Address - Country:US
Mailing Address - Phone:909-238-6400
Mailing Address - Fax:951-695-1832
Practice Address - Street 1:30520 RANCHO CALIFORNIA RD
Practice Address - Street 2:STE.10783
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591-3212
Practice Address - Country:US
Practice Address - Phone:909-238-6400
Practice Address - Fax:951-695-1832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-23
Last Update Date:2015-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty