Provider Demographics
NPI:1770163164
Name:FREE YOUR MIND COUNSELING, INC.
Entity type:Organization
Organization Name:FREE YOUR MIND COUNSELING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PRESIDENT, CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:PATRICIA
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, NCC, MED
Authorized Official - Phone:574-400-5158
Mailing Address - Street 1:22791 JUNEBERRY CT
Mailing Address - Street 2:
Mailing Address - City:ELKHART
Mailing Address - State:IN
Mailing Address - Zip Code:46514-9152
Mailing Address - Country:US
Mailing Address - Phone:574-400-5158
Mailing Address - Fax:574-701-2700
Practice Address - Street 1:22791 JUNEBERRY CT
Practice Address - Street 2:
Practice Address - City:ELKHART
Practice Address - State:IN
Practice Address - Zip Code:46514-9152
Practice Address - Country:US
Practice Address - Phone:574-400-5158
Practice Address - Fax:574-701-2700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-10
Last Update Date:2021-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health