Provider Demographics
NPI:1316206170
Name:SOLUTIONS FOR MINDFULNESS, PA
Entity type:Organization
Organization Name:SOLUTIONS FOR MINDFULNESS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-992-3796
Mailing Address - Street 1:10801 HICKORY RIDGE RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-3869
Mailing Address - Country:US
Mailing Address - Phone:410-992-3796
Mailing Address - Fax:410-992-3973
Practice Address - Street 1:10801 HICKORY RIDGE RD
Practice Address - Street 2:SUITE 210
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-3869
Practice Address - Country:US
Practice Address - Phone:410-992-3796
Practice Address - Fax:410-992-3973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-14
Last Update Date:2012-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC4180101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty