Provider Demographics
NPI:1083390355
Name:MINDFULLNESS PLLC
Entity Type:Organization
Organization Name:MINDFULLNESS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:GUERRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-729-6333
Mailing Address - Street 1:84 NE LOOP 410 STE 267
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-8406
Mailing Address - Country:US
Mailing Address - Phone:210-729-6333
Mailing Address - Fax:210-756-6219
Practice Address - Street 1:84 NE LOOP 410 STE 267
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-8406
Practice Address - Country:US
Practice Address - Phone:210-729-6333
Practice Address - Fax:210-756-6219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-22
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty