Provider Demographics
NPI:1255012423
Name:INTUIMIND INDIVIDUAL AND COUPLES COUNSELING INC.
Entity type:Organization
Organization Name:INTUIMIND INDIVIDUAL AND COUPLES COUNSELING INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LEE
Authorized Official - Middle Name:
Authorized Official - Last Name:ZELEDON
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:562-326-1382
Mailing Address - Street 1:9734 STATE HIGHWAY 281 # 5080
Mailing Address - Street 2:
Mailing Address - City:KELSEYVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95451-8401
Mailing Address - Country:US
Mailing Address - Phone:877-921-4119
Mailing Address - Fax:
Practice Address - Street 1:414 S MAIN ST
Practice Address - Street 2:
Practice Address - City:LAKEPORT
Practice Address - State:CA
Practice Address - Zip Code:95453-5316
Practice Address - Country:US
Practice Address - Phone:562-326-1382
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1689170250OtherNPI