Provider Demographics
NPI:1619838547
Name:THE MINDFUL WILLOW, LLC
Entity type:Organization
Organization Name:THE MINDFUL WILLOW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP
Authorized Official - Prefix:
Authorized Official - First Name:LINDSEY
Authorized Official - Middle Name:
Authorized Official - Last Name:CORD
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:765-918-7294
Mailing Address - Street 1:1777 N OLD STATE ROAD 55
Mailing Address - Street 2:
Mailing Address - City:CRAWFORDSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47933-8105
Mailing Address - Country:US
Mailing Address - Phone:765-918-7294
Mailing Address - Fax:765-356-9694
Practice Address - Street 1:127 E MAIN ST STE 104
Practice Address - Street 2:
Practice Address - City:CRAWFORDSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47933-1711
Practice Address - Country:US
Practice Address - Phone:765-754-4095
Practice Address - Fax:765-356-9694
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-20
Last Update Date:2025-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty