Provider Demographics
NPI:1831912419
Name:STEADYMIND THERAPY LLC
Entity type:Organization
Organization Name:STEADYMIND THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSA-BASHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-930-9189
Mailing Address - Street 1:PO BOX 250304
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48325-0304
Mailing Address - Country:US
Mailing Address - Phone:248-970-2163
Mailing Address - Fax:855-639-6781
Practice Address - Street 1:1447 CLUB DR
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-0705
Practice Address - Country:US
Practice Address - Phone:248-930-9189
Practice Address - Fax:855-639-6781
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-04
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty