Provider Demographics
NPI:1598390916
Name:MINDFUL RESOLVE COUNSELING, LLC
Entity Type:Organization
Organization Name:MINDFUL RESOLVE COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:BREANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-659-1915
Mailing Address - Street 1:7560 RANGEWOOD DR STE 210
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-2100
Mailing Address - Country:US
Mailing Address - Phone:719-725-1987
Mailing Address - Fax:888-425-0383
Practice Address - Street 1:7560 RANGEWOOD DR STE 210
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-2100
Practice Address - Country:US
Practice Address - Phone:719-725-1987
Practice Address - Fax:888-425-0383
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-05
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty