Provider Demographics
NPI:1467774356
Name:MINDFUL WELLBEING, LLC
Entity Type:Organization
Organization Name:MINDFUL WELLBEING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:T
Authorized Official - Last Name:ACKLAND
Authorized Official - Suffix:
Authorized Official - Credentials:NP, CNS
Authorized Official - Phone:508-833-1652
Mailing Address - Street 1:11 JILLSON WAY
Mailing Address - Street 2:
Mailing Address - City:EAST SANDWICH
Mailing Address - State:MA
Mailing Address - Zip Code:02537-1265
Mailing Address - Country:US
Mailing Address - Phone:508-833-1652
Mailing Address - Fax:774-413-9345
Practice Address - Street 1:11 JILLSON WAY
Practice Address - Street 2:
Practice Address - City:EAST SANDWICH
Practice Address - State:MA
Practice Address - Zip Code:02537-1265
Practice Address - Country:US
Practice Address - Phone:508-833-1652
Practice Address - Fax:774-413-9345
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-19
Last Update Date:2010-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA203553364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, AdultGroup - Single Specialty