Provider Demographics
NPI:1467210443
Name:MINDFUL PSYCHIATRIC & MENTAL WELLNESS SERVICES, PLLC
Entity Type:Organization
Organization Name:MINDFUL PSYCHIATRIC & MENTAL WELLNESS SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP-BC
Authorized Official - Prefix:
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:
Authorized Official - Last Name:NEALEY
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:571-358-1275
Mailing Address - Street 1:9117 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-5434
Mailing Address - Country:US
Mailing Address - Phone:571-358-1275
Mailing Address - Fax:888-274-3906
Practice Address - Street 1:9117 CHURCH ST
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-5434
Practice Address - Country:US
Practice Address - Phone:571-358-1275
Practice Address - Fax:888-274-3906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-13
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)