Provider Demographics
NPI:1831862523
Name:ENLIGHTENED MIND COUNSELING LLC
Entity type:Organization
Organization Name:ENLIGHTENED MIND COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:GURGEL
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:954-228-0856
Mailing Address - Street 1:1440 N PARK DR
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326-3207
Mailing Address - Country:US
Mailing Address - Phone:954-228-0856
Mailing Address - Fax:
Practice Address - Street 1:150 S PINE ISLAND RD
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-2669
Practice Address - Country:US
Practice Address - Phone:954-228-0856
Practice Address - Fax:855-794-0961
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-28
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty