Provider Demographics
NPI:1194555383
Name:MINDFUL INTEGRATIVE PSYCHIATRY
Entity type:Organization
Organization Name:MINDFUL INTEGRATIVE PSYCHIATRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PMHNP-BC, FNP-C
Authorized Official - Prefix:
Authorized Official - First Name:LEONA
Authorized Official - Middle Name:MACHELE
Authorized Official - Last Name:CHALJUB
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C, PMHNP-BC
Authorized Official - Phone:409-789-3951
Mailing Address - Street 1:2219 SEALY ST
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77550-2216
Mailing Address - Country:US
Mailing Address - Phone:409-789-3951
Mailing Address - Fax:
Practice Address - Street 1:2219 SEALY ST
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77550-2216
Practice Address - Country:US
Practice Address - Phone:409-789-3951
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-03
Last Update Date:2024-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health