Provider Demographics
NPI:1043053739
Name:MINDFUL CONNECTION COUNSELING
Entity type:Organization
Organization Name:MINDFUL CONNECTION COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:
Authorized Official - Last Name:HAYES
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:307-921-1352
Mailing Address - Street 1:632 HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:DOUGLAS
Mailing Address - State:WY
Mailing Address - Zip Code:82633-2739
Mailing Address - Country:US
Mailing Address - Phone:307-921-1352
Mailing Address - Fax:
Practice Address - Street 1:632 HARRISON ST
Practice Address - Street 2:
Practice Address - City:DOUGLAS
Practice Address - State:WY
Practice Address - Zip Code:82633-2739
Practice Address - Country:US
Practice Address - Phone:307-921-1352
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-18
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty