Provider Demographics
NPI:1245680768
Name:MIND AND SPIRIT COUNSELING
Entity type:Organization
Organization Name:MIND AND SPIRIT COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:BOWEN
Authorized Official - Suffix:
Authorized Official - Credentials:NCFBPPC
Authorized Official - Phone:336-612-1747
Mailing Address - Street 1:1926 BASIN CREEK RD
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27217-7353
Mailing Address - Country:US
Mailing Address - Phone:336-612-1747
Mailing Address - Fax:
Practice Address - Street 1:1926 BASIN CREEK RD
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27217-7353
Practice Address - Country:US
Practice Address - Phone:336-612-1747
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-15
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Single Specialty