Provider Demographics
NPI:1518765684
Name:MIND NOURISHMENT COUNSELING, PLLC
Entity type:Organization
Organization Name:MIND NOURISHMENT COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:INGLE
Authorized Official - Middle Name:
Authorized Official - Last Name:REID
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHC
Authorized Official - Phone:919-824-4386
Mailing Address - Street 1:1183 UNIVERSITY DR STE 105
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-8315
Mailing Address - Country:US
Mailing Address - Phone:919-824-4386
Mailing Address - Fax:
Practice Address - Street 1:411 WILLOW BROOK CT
Practice Address - Street 2:
Practice Address - City:MEBANE
Practice Address - State:NC
Practice Address - Zip Code:27302
Practice Address - Country:US
Practice Address - Phone:919-824-4386
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-05
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty