Provider Demographics
NPI:1124684253
Name:MINDFUL JOURNEY THERAPEUTIC SERVICES LLC
Entity type:Organization
Organization Name:MINDFUL JOURNEY THERAPEUTIC SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NINA
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANKLIN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:757-309-7027
Mailing Address - Street 1:732 THIMBLE SHOALS BLVD STE 702
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4256
Mailing Address - Country:US
Mailing Address - Phone:757-309-7027
Mailing Address - Fax:
Practice Address - Street 1:732 THIMBLE SHOALS BLVD STE 702
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4256
Practice Address - Country:US
Practice Address - Phone:757-309-7027
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CLINICAL HEALTH SYSTEMS CORP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-05-14
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty