Provider Demographics
NPI:1811545692
Name:MINDFULNESS JOURNEY COUNSELING PLLC
Entity Type:Organization
Organization Name:MINDFULNESS JOURNEY COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:TANYA
Authorized Official - Middle Name:
Authorized Official - Last Name:PEETE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-702-5544
Mailing Address - Street 1:8406 MABLEY HILL RD
Mailing Address - Street 2:
Mailing Address - City:FENTON
Mailing Address - State:MI
Mailing Address - Zip Code:48430-9454
Mailing Address - Country:US
Mailing Address - Phone:248-805-2422
Mailing Address - Fax:800-308-7087
Practice Address - Street 1:8406 MABLEY HILL RD
Practice Address - Street 2:
Practice Address - City:FENTON
Practice Address - State:MI
Practice Address - Zip Code:48430-9454
Practice Address - Country:US
Practice Address - Phone:248-805-2422
Practice Address - Fax:800-308-7087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-26
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health