Provider Demographics
NPI:1043846165
Name:SOUND MIND BEHAVIORAL WELLNESS
Entity type:Organization
Organization Name:SOUND MIND BEHAVIORAL WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:LAKIESHA
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-214-1766
Mailing Address - Street 1:5726 SOUTHWYCK BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-1510
Mailing Address - Country:US
Mailing Address - Phone:419-214-1766
Mailing Address - Fax:419-214-1792
Practice Address - Street 1:5726 SOUTHWYCK BLVD STE 200
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-1510
Practice Address - Country:US
Practice Address - Phone:419-214-1766
Practice Address - Fax:419-214-1792
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-20
Last Update Date:2025-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0444405Medicaid
OH0315327Medicaid
OH01-8165OtherOHIO MENTAL HEALTH & ADDICTION SERVICES
OH0294590Medicaid
OH0178465Medicaid
OH0406325Medicaid