Provider Demographics
NPI:1336718675
Name:MINDALIGN COUNSELING GROUP INC
Entity Type:Organization
Organization Name:MINDALIGN COUNSELING GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:GINGER
Authorized Official - Middle Name:
Authorized Official - Last Name:FREEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LSATP
Authorized Official - Phone:434-865-4217
Mailing Address - Street 1:924 W ATLANTIC ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH HILL
Mailing Address - State:VA
Mailing Address - Zip Code:23970-1825
Mailing Address - Country:US
Mailing Address - Phone:434-584-9814
Mailing Address - Fax:434-584-9484
Practice Address - Street 1:924 W ATLANTIC ST
Practice Address - Street 2:
Practice Address - City:SOUTH HILL
Practice Address - State:VA
Practice Address - Zip Code:23970-1825
Practice Address - Country:US
Practice Address - Phone:434-584-9814
Practice Address - Fax:434-584-9484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-21
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0718000466OtherVIRGINIA DEPARTMENT OF HEALTH PROFESSIONS
VA0701007513OtherDEPARTMENT OF HEALTH PROFESSIONS