Provider Demographics
NPI:1841822160
Name:EAGLE MINDSET COACHING AND COUNSELING LLC
Entity type:Organization
Organization Name:EAGLE MINDSET COACHING AND COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AHJA
Authorized Official - Middle Name:GAY
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-869-0469
Mailing Address - Street 1:4964 DARTMOUTH CT
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45011-9763
Mailing Address - Country:US
Mailing Address - Phone:513-869-0469
Mailing Address - Fax:
Practice Address - Street 1:10 S HIGHVIEW RD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:45044-5027
Practice Address - Country:US
Practice Address - Phone:513-869-0469
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-05
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health