Provider Demographics
NPI:1457194755
Name:MINDFUL SPACE COUNSELING
Entity type:Organization
Organization Name:MINDFUL SPACE COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ABBEY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:724-301-9176
Mailing Address - Street 1:129 FIRESIDE DR
Mailing Address - Street 2:
Mailing Address - City:MC MURRAY
Mailing Address - State:PA
Mailing Address - Zip Code:15317-3636
Mailing Address - Country:US
Mailing Address - Phone:724-301-9176
Mailing Address - Fax:
Practice Address - Street 1:57 W PIKE ST
Practice Address - Street 2:
Practice Address - City:CANONSBURG
Practice Address - State:PA
Practice Address - Zip Code:15317-1313
Practice Address - Country:US
Practice Address - Phone:724-301-9176
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-14
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)