Provider Demographics
NPI:1245053412
Name:RESILIENCE IS MINE THERAPY & CONSULTING SERVICES, LLC
Entity type:Organization
Organization Name:RESILIENCE IS MINE THERAPY & CONSULTING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CASSANDRA
Authorized Official - Middle Name:JUANITA
Authorized Official - Last Name:MARTIN-WEILER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LISW-S
Authorized Official - Phone:614-329-6218
Mailing Address - Street 1:PO BOX 133
Mailing Address - Street 2:
Mailing Address - City:BLACKLICK
Mailing Address - State:OH
Mailing Address - Zip Code:43004-0133
Mailing Address - Country:US
Mailing Address - Phone:614-329-6218
Mailing Address - Fax:
Practice Address - Street 1:11630 BROAD ST SW
Practice Address - Street 2:
Practice Address - City:PATASKALA
Practice Address - State:OH
Practice Address - Zip Code:43062-8195
Practice Address - Country:US
Practice Address - Phone:614-329-6218
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-05
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty