Provider Demographics
NPI:1780482257
Name:MASTERMIND COUNSELING SERVICES, LLC
Entity type:Organization
Organization Name:MASTERMIND COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ZOEY
Authorized Official - Middle Name:
Authorized Official - Last Name:KYRIACOU
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:908-768-7039
Mailing Address - Street 1:203 BURNSIDE AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:CRANFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07016-2601
Mailing Address - Country:US
Mailing Address - Phone:908-768-7039
Mailing Address - Fax:
Practice Address - Street 1:615 SHERWOOD PKWY STE 7
Practice Address - Street 2:
Practice Address - City:MOUNTAINSIDE
Practice Address - State:NJ
Practice Address - Zip Code:07092-2525
Practice Address - Country:US
Practice Address - Phone:908-768-7039
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty