Organization
MIND TRUST COUNSELING AND CONSULTING SERVICES,PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. VANESSA LORRAINE LEWIS LLPC (CHIEF EXECUTIVE OFFICER)
(313) 595-3125
Entity
Organization
Contact information
Practice address
16250 NORTHLAND DR STE 115, SOUTHFIELD, MI 48075-5221
(313) 595-3125
(313) 447-2277
Mailing address
16250 NORTHLAND DR STE 115, SOUTHFIELD, MI 48075-5221
(313) 595-3125
(313) 447-2277
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
6401012459
MI
Other
Enumeration date
07/26/2014
Last updated
07/26/2014
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