Provider Demographics
NPI:1841982949
Name:PEACE OF MIND & LIFE COUNSELING PLLC
Entity type:Organization
Organization Name:PEACE OF MIND & LIFE COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEHAVIORAL HEALTH EXECUTIVE
Authorized Official - Prefix:
Authorized Official - First Name:JAMEELAH
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN-WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-599-3386
Mailing Address - Street 1:7601 S KOSTNER AVE STE 202G
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60652-1126
Mailing Address - Country:US
Mailing Address - Phone:872-215-2517
Mailing Address - Fax:
Practice Address - Street 1:7601 S KOSTNER AVE STE 202G
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60652-1126
Practice Address - Country:US
Practice Address - Phone:872-215-2517
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-25
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL433416833Medicaid