Provider Demographics
NPI:1366021305
Name:MAULDIN, MINDY RENEE (LPC)
Entity Type:Individual
Prefix:
First Name:MINDY
Middle Name:RENEE
Last Name:MAULDIN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5750 RUFE SNOW DR STE 150A
Mailing Address - Street 2:
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76180-6156
Mailing Address - Country:US
Mailing Address - Phone:817-438-6012
Mailing Address - Fax:
Practice Address - Street 1:5750 RUFE SNOW DR STE 150A
Practice Address - Street 2:
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76180-6156
Practice Address - Country:US
Practice Address - Phone:682-207-7233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-06
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX85468101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health