Provider Demographics
NPI:1649548272
Name:PEACE OF MIND COUNSELING CENTER
Entity type:Organization
Organization Name:PEACE OF MIND COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:LOEFFLER
Authorized Official - Last Name:ZIEBARTH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:269-428-4789
Mailing Address - Street 1:3408 NILES RD
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MI
Mailing Address - Zip Code:49085-9601
Mailing Address - Country:US
Mailing Address - Phone:269-428-4789
Mailing Address - Fax:269-408-0084
Practice Address - Street 1:3408 NILES RD
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MI
Practice Address - Zip Code:49085-9601
Practice Address - Country:US
Practice Address - Phone:269-428-4789
Practice Address - Fax:269-408-0084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-10
Last Update Date:2011-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301008479103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MION77560Medicare UPIN