Provider Demographics
NPI:1467024240
Name:SOUND MIND COACHING AND CONSULTING, LLC
Entity type:Organization
Organization Name:SOUND MIND COACHING AND CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MIRANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:ONEAL
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:205-542-0291
Mailing Address - Street 1:210 FIELDSTOWN RD STE 100
Mailing Address - Street 2:
Mailing Address - City:GARDENDALE
Mailing Address - State:AL
Mailing Address - Zip Code:35071-2418
Mailing Address - Country:US
Mailing Address - Phone:205-542-0291
Mailing Address - Fax:
Practice Address - Street 1:210 FIELDSTOWN RD STE 100
Practice Address - Street 2:
Practice Address - City:GARDENDALE
Practice Address - State:AL
Practice Address - Zip Code:35071-2418
Practice Address - Country:US
Practice Address - Phone:205-542-0291
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-12
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service