Provider Demographics
NPI:1932920998
Name:MINDFUL SOLUTIONS MENTAL HEALTH CARE
Entity type:Organization
Organization Name:MINDFUL SOLUTIONS MENTAL HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:CARESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:KAOUGH
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:337-513-8036
Mailing Address - Street 1:5455 HEBERTS PASS
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70607-7705
Mailing Address - Country:US
Mailing Address - Phone:337-513-8036
Mailing Address - Fax:
Practice Address - Street 1:5455 HEBERTS PASS
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70607-7705
Practice Address - Country:US
Practice Address - Phone:337-513-8036
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-22
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty