Provider Demographics
NPI:1427867563
Name:MINDFUL TALK LLC
Entity type:Organization
Organization Name:MINDFUL TALK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENEL
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:202-681-4492
Mailing Address - Street 1:9103 WOODMORE CENTER DR STE 222
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-1653
Mailing Address - Country:US
Mailing Address - Phone:202-681-4492
Mailing Address - Fax:
Practice Address - Street 1:2029 WOODSHADE CT
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20721-4142
Practice Address - Country:US
Practice Address - Phone:202-681-4492
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-03
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)