Provider Demographics
NPI:1386322915
Name:SOUND MIND COUNSELING CENTER, LLC
Entity type:Organization
Organization Name:SOUND MIND COUNSELING CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO & MENTAL HEALTH THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:SELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:856-452-1021
Mailing Address - Street 1:532 OLD MARLTON PIKE W #524
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053
Mailing Address - Country:US
Mailing Address - Phone:856-452-1021
Mailing Address - Fax:
Practice Address - Street 1:1202 JONATHAN LN
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-4520
Practice Address - Country:US
Practice Address - Phone:856-452-1021
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-05
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty