Provider Demographics
NPI:1619678356
Name:MINDFUL WELLNESS RESET: RELAX, RELEASE & RENEW, PLLC
Entity Type:Organization
Organization Name:MINDFUL WELLNESS RESET: RELAX, RELEASE & RENEW, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PH.D., LMFT, LPC, LMSW
Authorized Official - Prefix:DR
Authorized Official - First Name:CATINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LMFT, LPC
Authorized Official - Phone:972-302-8667
Mailing Address - Street 1:8700 STONEBROOK PKWY UNIT 962
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-5804
Mailing Address - Country:US
Mailing Address - Phone:972-302-8667
Mailing Address - Fax:
Practice Address - Street 1:13291 GUERIN DR
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-9171
Practice Address - Country:US
Practice Address - Phone:972-302-8667
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-10
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty