Organization
STATE OF MIND THERAPY SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY KILROY LMHC (OWNER/THERAPIST)
(219) 230-8311
Entity
Organization
Contact information
Practice address
55 SHORE DR, PORTAGE, IN 46368-1008
(219) 230-8311
Mailing address
709 PLAZA DR., SUITE 2 PMB 279, CHESTERTON, IN 46304-1572
(219) 230-8311
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
09/22/2023
Last updated
11/16/2023
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