Provider Demographics
NPI:1790352490
Name:MASTERMINDS CLINICAL COUNSELING & CONSULTING FIRM LLC
Entity Type:Organization
Organization Name:MASTERMINDS CLINICAL COUNSELING & CONSULTING FIRM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICIAN
Authorized Official - Prefix:MS
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:LLOYD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C, LCSW
Authorized Official - Phone:301-573-4681
Mailing Address - Street 1:880 MANDALAY AVE APT N702
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33767-1227
Mailing Address - Country:US
Mailing Address - Phone:301-573-4681
Mailing Address - Fax:
Practice Address - Street 1:880 MANDALAY AVE APT N702
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33767-1227
Practice Address - Country:US
Practice Address - Phone:301-573-4681
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-10
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty