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Organization
MODERN MIND THERAPY & LIFE COACHING LLC
Active
Organization
MODERN MIND THERAPY & LIFE COACHING LLC
Active
Other names
Modern Mind Therapy & Life Coaching LLC
Organization subpart
No
Provider details
NPI number
Authorized official
LAKEISHA GRAYER LPC (OWNER)
(757) 303-7808
Entity
Organization
Contact information
Practice address
4601 FAIRFAX DR STE 1200, ARLINGTON, VA 22203-1559
(757) 303-7808
Mailing address
13645 LEGACY CIR APT A, HERNDON, VA 20171-5265
(175) 730-3780
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1467077651
NPI
VA
Enumeration date
03/28/2021
Last updated
04/05/2021
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