Provider Demographics
NPI:1023998481
Name:MIND MAKEOVER THERAPY
Entity type:Organization
Organization Name:MIND MAKEOVER THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL THERAPISY
Authorized Official - Prefix:MS
Authorized Official - First Name:BRANDIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDERS
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:810-228-6186
Mailing Address - Street 1:6272 S SAGINAW RD
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-2705
Mailing Address - Country:US
Mailing Address - Phone:810-447-0150
Mailing Address - Fax:
Practice Address - Street 1:2116 CARTIER ST
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48504-4639
Practice Address - Country:US
Practice Address - Phone:810-447-0150
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-05
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty