Provider Demographics
NPI:1114649001
Name:MINDFUL TRANSFORMATIONS COUNSELING CENTER
Entity type:Organization
Organization Name:MINDFUL TRANSFORMATIONS COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:COUSETTE
Authorized Official - Last Name:MILLS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-S, CHT, BC-TMH
Authorized Official - Phone:205-614-3012
Mailing Address - Street 1:SKYLAND WEST PROFESSIONAL PLAZA
Mailing Address - Street 2:423 SKYLAND BLVD, SUITE A-7
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35405
Mailing Address - Country:US
Mailing Address - Phone:205-614-3012
Mailing Address - Fax:205-469-9343
Practice Address - Street 1:SKYLAND WEST PROFESSIONAL PLAZA
Practice Address - Street 2:423 SKYLAND BLVD, SUITE A-7
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35405
Practice Address - Country:US
Practice Address - Phone:205-614-3012
Practice Address - Fax:205-469-9343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-16
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health