Provider Demographics
NPI:1841657145
Name:AWAKENED MIND, PLLC
Entity type:Organization
Organization Name:AWAKENED MIND, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:JEANETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:SESHADRI
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:281-905-1959
Mailing Address - Street 1:35 RIPPLING CREEK DR
Mailing Address - Street 2:
Mailing Address - City:SUGARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479
Mailing Address - Country:US
Mailing Address - Phone:281-905-1959
Mailing Address - Fax:281-480-4641
Practice Address - Street 1:12920 DAIRY ASHFORD RD
Practice Address - Street 2:105
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-3177
Practice Address - Country:US
Practice Address - Phone:281-905-1959
Practice Address - Fax:281-480-4641
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-19
Last Update Date:2016-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68094101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty