Provider Demographics
NPI:1346021821
Name:MINDFUL-LATINX LLC
Entity Type:Organization
Organization Name:MINDFUL-LATINX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LORIEANN
Authorized Official - Middle Name:
Authorized Official - Last Name:HEREDIA-SOLANO
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:407-496-9748
Mailing Address - Street 1:10934 SAVANNAH WOOD DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32832-5573
Mailing Address - Country:US
Mailing Address - Phone:407-496-9748
Mailing Address - Fax:
Practice Address - Street 1:10934 SAVANNAH WOOD DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32832-5573
Practice Address - Country:US
Practice Address - Phone:407-496-9748
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-10
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty