Provider Demographics
NPI:1205297066
Name:PEACE OF MIND PERSONAL GROWTH AND THERAPEUTIC SERVICES
Entity type:Organization
Organization Name:PEACE OF MIND PERSONAL GROWTH AND THERAPEUTIC SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:BOSTON
Authorized Official - Last Name:HICKERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-336-2308
Mailing Address - Street 1:124 AMHERST ST
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-4114
Mailing Address - Country:US
Mailing Address - Phone:540-336-2308
Mailing Address - Fax:
Practice Address - Street 1:116 W PICCADILLY ST STE 10
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-3965
Practice Address - Country:US
Practice Address - Phone:540-336-2308
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-08
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty