Provider Demographics
NPI:1912525213
Name:A BEAUTIFUL MIND THERAPY SERVICES PLLC
Entity Type:Organization
Organization Name:A BEAUTIFUL MIND THERAPY SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHERITA
Authorized Official - Middle Name:INEZ
Authorized Official - Last Name:BROWNLEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-977-5272
Mailing Address - Street 1:91 N SAGINAW ST STE G-101
Mailing Address - Street 2:
Mailing Address - City:PONTIAC
Mailing Address - State:MI
Mailing Address - Zip Code:48342-2165
Mailing Address - Country:US
Mailing Address - Phone:248-977-5272
Mailing Address - Fax:586-685-2475
Practice Address - Street 1:91 N SAGINAW ST STE G-101
Practice Address - Street 2:
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48342-2165
Practice Address - Country:US
Practice Address - Phone:586-646-8259
Practice Address - Fax:586-685-2475
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-13
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty