Provider Demographics
NPI:1447844915
Name:RESILIENT MIND COUNSELING LLC
Entity type:Organization
Organization Name:RESILIENT MIND COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TONI
Authorized Official - Middle Name:J
Authorized Official - Last Name:CALDWELL
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:463-442-2756
Mailing Address - Street 1:21102 FOX WALK TRL
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-1481
Mailing Address - Country:US
Mailing Address - Phone:812-674-4518
Mailing Address - Fax:
Practice Address - Street 1:16770 IMPERIAL VALLEY DR STE 125O
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77060-3407
Practice Address - Country:US
Practice Address - Phone:346-442-2756
Practice Address - Fax:281-913-5000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-25
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4185357Medicaid