Provider Demographics
NPI:1568147569
Name:MINDFUL LIFE COUNSELING, PLLC
Entity Type:Organization
Organization Name:MINDFUL LIFE COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:CAGLE
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:972-533-1788
Mailing Address - Street 1:17330 PRESTON ROAD
Mailing Address - Street 2:SUITE 200D #251
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75252-6106
Mailing Address - Country:US
Mailing Address - Phone:972-533-1788
Mailing Address - Fax:
Practice Address - Street 1:17330 PRESTON ROAD
Practice Address - Street 2:SUITE 200D #251
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75252-6106
Practice Address - Country:US
Practice Address - Phone:972-533-1788
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-16
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty