Provider Demographics
NPI:1922636323
Name:PEACE OF MIND COUNSELING, PLLC
Entity Type:Organization
Organization Name:PEACE OF MIND COUNSELING, PLLC
Other - Org Name:PEACE OF MIND COUNSELING
Other - Org Type:Other Name
Authorized Official - Title/Position:MENTAL HEALTH COUNSELOR/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:LANGAN
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:701-202-5908
Mailing Address - Street 1:2718 GATEWAY AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58503-0585
Mailing Address - Country:US
Mailing Address - Phone:701-202-5908
Mailing Address - Fax:
Practice Address - Street 1:2718 GATEWAY AVE STE 104
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58503-0585
Practice Address - Country:US
Practice Address - Phone:701-202-5908
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-31
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND1468750Medicaid