Provider Demographics
NPI:1730935990
Name:PEACEFUL MINDS THERAPY CENTER
Entity type:Organization
Organization Name:PEACEFUL MINDS THERAPY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PAULINE
Authorized Official - Middle Name:
Authorized Official - Last Name:BELTON
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:703-712-1049
Mailing Address - Street 1:14201 LAUREL PARK DR STE 221
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-5203
Mailing Address - Country:US
Mailing Address - Phone:703-712-1049
Mailing Address - Fax:
Practice Address - Street 1:14201 LAUREL PARK DR STE 221
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-5203
Practice Address - Country:US
Practice Address - Phone:703-712-1049
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PEACEFUL MINDS THERAPY CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-04-29
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty