Provider Demographics
NPI:1548562036
Name:MINDFUL MATTERS, LLC
Entity Type:Organization
Organization Name:MINDFUL MATTERS, LLC
Other - Org Name:MINDFUL MATTERS LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DELEGATED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:MELINA
Authorized Official - Middle Name:MARGARET
Authorized Official - Last Name:SOMMERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-652-7755
Mailing Address - Street 1:19563 E MAINSTREET
Mailing Address - Street 2:SUITE 206-H
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138-7367
Mailing Address - Country:US
Mailing Address - Phone:303-505-8355
Mailing Address - Fax:
Practice Address - Street 1:19563 E MAINSTREET STE 206H
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138-7367
Practice Address - Country:US
Practice Address - Phone:303-505-8355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-03
Last Update Date:2018-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD131261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1295759785OtherINDIVIDUAL NPI NUMBER