| Peace Of Mind Therapy, Pllc | |
|
2615 W 12 Mile Rd Ste 119 Berkley MI 48072-1627 | |
| (248) 397-4705 | |
| Not Available |
| Full Name | Peace Of Mind Therapy, Pllc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 2615 W 12 Mile Rd Ste 119, Berkley, Michigan |
| Authorized Official Name and Position | Lauren Lucielle Provencher (OWNER/CLINICAL THERAPIST) |
| Authorized Official Contact | 2483974705 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Peace Of Mind Therapy, Pllc 2615 W 12 Mile Rd Ste 119 Berkley MI 48072-1627 Ph: (248) 397-4705 | Peace Of Mind Therapy, Pllc 2615 W 12 Mile Rd Ste 119 Berkley MI 48072-1627 Ph: (248) 397-4705 |
| NPI Number | 1730683368 |
|---|---|
| Provider Enumeration Date | 03/20/2018 |
| Last Update Date | 05/05/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730683368 | NPI | - | NPPES |
| 1285918631 | Other | MI | BCBS/BCN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 6801093391 (Michigan) | Primary |
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