Provider Demographics
NPI:1336866243
Name:PEACEFUL MIND COUNSELING AND CONSULTING, LLC
Entity Type:Organization
Organization Name:PEACEFUL MIND COUNSELING AND CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:ROBIN
Authorized Official - Last Name:KRAUSE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:417-501-5416
Mailing Address - Street 1:3003 E CHESTNUT EXPY STE 800
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65802-6311
Mailing Address - Country:US
Mailing Address - Phone:417-501-5416
Mailing Address - Fax:844-444-0518
Practice Address - Street 1:3003 E CHESTNUT EXPY STE 800
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65802-6311
Practice Address - Country:US
Practice Address - Phone:417-501-5416
Practice Address - Fax:844-444-0518
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-21
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty