Provider Demographics
NPI:1861096745
Name:MINDFUL COUNSELING LLC
Entity type:Organization
Organization Name:MINDFUL COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:NORMAND
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:857-286-0347
Mailing Address - Street 1:31 CONCORD AVE APT 14
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-2332
Mailing Address - Country:US
Mailing Address - Phone:978-502-9171
Mailing Address - Fax:
Practice Address - Street 1:31 CONCORD AVE APT 14
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-2332
Practice Address - Country:US
Practice Address - Phone:978-502-9171
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-23
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)