Provider Demographics
NPI:1669239596
Name:PEACE OF MIND CHRISTIAN COUNSELING, LLC
Entity type:Organization
Organization Name:PEACE OF MIND CHRISTIAN COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARKIETA
Authorized Official - Middle Name:JOYCE
Authorized Official - Last Name:BOSWELL
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:248-210-8380
Mailing Address - Street 1:15900 W. 10 MILE RD
Mailing Address - Street 2:STE. 211 #424
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075
Mailing Address - Country:US
Mailing Address - Phone:240-923-0053
Mailing Address - Fax:240-368-5375
Practice Address - Street 1:29777 TELEGRAPH RD., #1350
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034
Practice Address - Country:US
Practice Address - Phone:240-923-0053
Practice Address - Fax:240-368-5375
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-06
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty