Provider Demographics
NPI:1134596463
Name:MINDINPROGRESS COUNSELING LLC
Entity type:Organization
Organization Name:MINDINPROGRESS COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:J
Authorized Official - Last Name:DAMON
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:508-493-2028
Mailing Address - Street 1:556 CENTRE ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:MIDDLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02346-2162
Mailing Address - Country:US
Mailing Address - Phone:508-493-2028
Mailing Address - Fax:
Practice Address - Street 1:556 CENTRE ST
Practice Address - Street 2:SUITE E
Practice Address - City:MIDDLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02346-2162
Practice Address - Country:US
Practice Address - Phone:508-493-2028
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-21
Last Update Date:2015-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty