Provider Demographics
NPI:1528631629
Name:LIBERATED MIND COUNSELING LLC
Entity type:Organization
Organization Name:LIBERATED MIND COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:BRANDEN
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:BARNETT
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC-S
Authorized Official - Phone:727-451-9281
Mailing Address - Street 1:447 3RD AVE N STE 310
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-3245
Mailing Address - Country:US
Mailing Address - Phone:727-451-9281
Mailing Address - Fax:
Practice Address - Street 1:447 3RD AVE N STE 310
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-3245
Practice Address - Country:US
Practice Address - Phone:727-451-9281
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-19
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty