Provider Demographics
NPI:1629577093
Name:MINDFUL WARRIOR INSTITUTE, LLC
Entity Type:Organization
Organization Name:MINDFUL WARRIOR INSTITUTE, LLC
Other - Org Name:MINDFUL WARRIOR INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:WAHKINNEY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:405-300-5849
Mailing Address - Street 1:7300 NW 23RD ST STE 301
Mailing Address - Street 2:
Mailing Address - City:BETHANY
Mailing Address - State:OK
Mailing Address - Zip Code:73008-5128
Mailing Address - Country:US
Mailing Address - Phone:405-481-0701
Mailing Address - Fax:
Practice Address - Street 1:7916 NW 23RD ST # 199
Practice Address - Street 2:
Practice Address - City:BETHANY
Practice Address - State:OK
Practice Address - Zip Code:73008-4950
Practice Address - Country:US
Practice Address - Phone:405-481-0701
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-12
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK6463101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty