Provider Demographics
NPI:1609412956
Name:MINDFUL CONSULTATION INC.
Entity Type:Organization
Organization Name:MINDFUL CONSULTATION INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:CHMIELEWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:773-836-9509
Mailing Address - Street 1:1946 N NATOMA AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60707-3920
Mailing Address - Country:US
Mailing Address - Phone:773-836-9509
Mailing Address - Fax:
Practice Address - Street 1:1010 LAKE ST STE 502A
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60301-1135
Practice Address - Country:US
Practice Address - Phone:773-430-9519
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-21
Last Update Date:2019-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty