Organization
EASE OF MIND COUNSELING SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA MARITA JOHNSON LMHC (THERAPIST)
(812) 820-3061
Entity
Organization
Contact information
Practice address
639 N SHEA RD, SCOTTSBURG, IN 47170-8132
(812) 820-3061
Mailing address
639 N SHEA RD, SCOTTSBURG, IN 47170-8132
(812) 820-3061
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1043827991
NPI TYPE 1
—
01
—
39003807A
PROFESSIONAL LICENSE
IN
Enumeration date
07/01/2021
Last updated
07/01/2021
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