Provider Demographics
NPI:1326650169
Name:MINDFULNESS COUNSELING ASSOCIATES, LLC
Entity Type:Organization
Organization Name:MINDFULNESS COUNSELING ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCNAMARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-789-1224
Mailing Address - Street 1:8249 CROWN COLONY PKWY STE 202
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23116-4057
Mailing Address - Country:US
Mailing Address - Phone:804-789-1224
Mailing Address - Fax:
Practice Address - Street 1:8249 CROWN COLONY PKWY STE 202
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23116-4057
Practice Address - Country:US
Practice Address - Phone:804-789-1224
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-22
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty