Provider Demographics
NPI:1417705872
Name:MIND AND MOTION PLLC
Entity type:Organization
Organization Name:MIND AND MOTION PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPC/CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:PIAZZA
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:903-251-9650
Mailing Address - Street 1:7925 S BROADWAY AVE STE 920
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-5227
Mailing Address - Country:US
Mailing Address - Phone:903-251-9650
Mailing Address - Fax:
Practice Address - Street 1:7925 S BROADWAY AVE STE 920
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703-5227
Practice Address - Country:US
Practice Address - Phone:903-282-5205
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-10
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty