MODERN MIND THERAPY & LIFE COACHING LLC NPI 1003493610

NPI Information

NPI: 1003493610
Provider Name: MODERN MIND THERAPY & LIFE COACHING LLC

Former Legal Business Name: MODERN MIND THERAPY & LIFE COACHING LLC

Classification: Counselor - 101YP2500X
Entity Type: Organization

Specialization: Professional

Address:
4601 FAIRFAX DR STE 1200
ARLINGTON, VA
ZIP 22203
Phone: (757) 303-7808
Get Directions

MODERN MIND THERAPY & LIFE COACHING LLC is a professional counselor in Arlington, VA. MODERN MIND THERAPY & LIFE COACHING LLC NPI is 1003493610. The provider is registered as an organization entity type and is a single specialty group.
The provider Former Legal Business Name Is Modern Mind Therapy & Life Coaching Llc.

The provider's business location address is:

4601 FAIRFAX DR STE 1200
ARLINGTON, VA
ZIP 22203-559
Phone: (757) 303-7808

The provider's authorized official is Lakeisha Grayer .
The authorized official title is Owner and has the following contact phone number (757) 303-7808.

The enumeration date for this NPI number is 3/28/2021 and was last updated on 4/5/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YP2500X	Counselor	Professional			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1467077651	OTHER	VIRGINIA	NPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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