Provider Demographics
NPI:1386498970
Name:MINDFUL HEALING COUNSELING LLC
Entity type:Organization
Organization Name:MINDFUL HEALING COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TEAL
Authorized Official - Middle Name:
Authorized Official - Last Name:SARGENT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:808-635-4371
Mailing Address - Street 1:PO BOX 200
Mailing Address - Street 2:
Mailing Address - City:KILAUEA
Mailing Address - State:HI
Mailing Address - Zip Code:96754-0200
Mailing Address - Country:US
Mailing Address - Phone:808-635-4371
Mailing Address - Fax:
Practice Address - Street 1:5-4280 KUHIO HWY STE G-210C
Practice Address - Street 2:
Practice Address - City:PRINCEVILLE
Practice Address - State:HI
Practice Address - Zip Code:96722-1700
Practice Address - Country:US
Practice Address - Phone:808-635-4371
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-11
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral Health