1740553080 NPI number — MIND AND SPIRIT COUNSELING AND EDUCATION SERVICES LLC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740553080 NPI number — MIND AND SPIRIT COUNSELING AND EDUCATION SERVICES LLC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MIND AND SPIRIT COUNSELING AND EDUCATION SERVICES LLC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1740553080
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/21/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3195 DAYTON XENIA RD, PMB 108, STE 900
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BEAVERCREEK
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45434-6390
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
937-520-8437
Provider Business Mailing Address Fax Number:
937-320-9630

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1407 NEW WAY DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BEAVERCREEK
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45434-6925
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
937-520-8437
Provider Business Practice Location Address Fax Number:
937-320-9630
Provider Enumeration Date:
02/16/2012

Additional Information

Authorized Official

Authorized Official Last Name:
STOBIE
Authorized Official First Name:
MARK
Authorized Official Middle Name:
RUSSELL
Authorized Official Title or Position:
OWNER/PROVIDER
Authorized Official Telephone Number:
937-520-8437

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  E 0501350 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com