Provider Demographics
NPI:1225747330
Name:MINDFUL FOUNDATIONS THERAPY LLC
Entity Type:Organization
Organization Name:MINDFUL FOUNDATIONS THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PYSCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KARA
Authorized Official - Middle Name:
Authorized Official - Last Name:KIRKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-965-5607
Mailing Address - Street 1:3 MEADOW RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WESTERLY
Mailing Address - State:RI
Mailing Address - Zip Code:02891-4001
Mailing Address - Country:US
Mailing Address - Phone:401-965-5607
Mailing Address - Fax:
Practice Address - Street 1:24 SALT POND RD STE B4
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:RI
Practice Address - Zip Code:02879-4320
Practice Address - Country:US
Practice Address - Phone:800-965-5607
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-17
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty