Organization
BLUE MIND COUNSELING PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELLENORE SCOTT L.C.S.W (THERAPIST)
(310) 490-0072
Entity
Organization
Contact information
Practice address
2501 CHATHAM RD STE 8042, SPRINGFIELD, IL 62704-4188
(310) 490-0072
Mailing address
2501 CHATHAM RD STE R, SPRINGFIELD, IL 62704-4188
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
03/22/2022
Last updated
03/22/2022
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