Provider Demographics
NPI:1972152940
Name:MIND STANCE INC
Entity type:Organization
Organization Name:MIND STANCE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOTHERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:L
Authorized Official - Last Name:WEIRAUCH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:773-980-6505
Mailing Address - Street 1:6423 N GREENVIEW AVE APT 3W
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60626-6182
Mailing Address - Country:US
Mailing Address - Phone:303-525-6697
Mailing Address - Fax:872-231-0066
Practice Address - Street 1:5443 N BROADWAY ST FL 2
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-1703
Practice Address - Country:US
Practice Address - Phone:773-980-6505
Practice Address - Fax:872-231-0066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-11
Last Update Date:2020-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty