Provider Demographics
NPI:1639755879
Name:MINDFUL THERAPY CONNECTIONS LLC
Entity Type:Organization
Organization Name:MINDFUL THERAPY CONNECTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:TYEESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-973-1060
Mailing Address - Street 1:8333 MEADOWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:MD
Mailing Address - Zip Code:21076-2248
Mailing Address - Country:US
Mailing Address - Phone:703-973-1060
Mailing Address - Fax:
Practice Address - Street 1:8333 MEADOWOOD DR
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:MD
Practice Address - Zip Code:21076-2248
Practice Address - Country:US
Practice Address - Phone:703-973-1060
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-18
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty