Provider Demographics
NPI:1699667196
Name:GLASS HALF MINDFUL LLC
Entity type:Organization
Organization Name:GLASS HALF MINDFUL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:J
Authorized Official - Last Name:RADIE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:971-270-0308
Mailing Address - Street 1:6600 SE TAGGART ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97206-1259
Mailing Address - Country:US
Mailing Address - Phone:971-270-0308
Mailing Address - Fax:
Practice Address - Street 1:6600 SE TAGGART ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97206-1259
Practice Address - Country:US
Practice Address - Phone:971-270-0308
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-17
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health