Provider Demographics
NPI:1598544181
Name:MINDFUL HEALING THERAPEUTIC SERVICES LLC
Entity Type:Organization
Organization Name:MINDFUL HEALING THERAPEUTIC SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:GOFF
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:240-397-1540
Mailing Address - Street 1:504 GATEWAY DR W
Mailing Address - Street 2:
Mailing Address - City:THURMONT
Mailing Address - State:MD
Mailing Address - Zip Code:21788-3202
Mailing Address - Country:US
Mailing Address - Phone:240-397-1540
Mailing Address - Fax:
Practice Address - Street 1:504 GATEWAY DR W
Practice Address - Street 2:
Practice Address - City:THURMONT
Practice Address - State:MD
Practice Address - Zip Code:21788-3202
Practice Address - Country:US
Practice Address - Phone:240-397-1540
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-25
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health