Provider Demographics
NPI:1063051332
Name:MIND CONNECTIONS, LLC
Entity type:Organization
Organization Name:MIND CONNECTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KENDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:DIXSON
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW - CLINICAL
Authorized Official - Phone:248-835-5705
Mailing Address - Street 1:41000 WOODWARD AVE STE 350
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48304-5092
Mailing Address - Country:US
Mailing Address - Phone:248-900-1980
Mailing Address - Fax:248-590-2867
Practice Address - Street 1:41000 WOODWARD AVE STE 350
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48304-5092
Practice Address - Country:US
Practice Address - Phone:248-835-5705
Practice Address - Fax:248-590-2867
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-03
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty