Provider Demographics
NPI:1467227876
Name:MINDFUL TRANSITIONS, LLC
Entity Type:Organization
Organization Name:MINDFUL TRANSITIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCPC
Authorized Official - Prefix:
Authorized Official - First Name:KERRY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:HAMPTON
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:239-745-5285
Mailing Address - Street 1:10413 BROOKRIDGE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:IL
Mailing Address - Zip Code:60423-8089
Mailing Address - Country:US
Mailing Address - Phone:123-974-5528
Mailing Address - Fax:
Practice Address - Street 1:10413 BROOKRIDGE CREEK DR
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:IL
Practice Address - Zip Code:60423-8089
Practice Address - Country:US
Practice Address - Phone:123-974-5528
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-16
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty