Provider Demographics
NPI:1679235527
Name:A MINDFUL TALK HEALTH SERVICES LCSW, PLLC
Entity Type:Organization
Organization Name:A MINDFUL TALK HEALTH SERVICES LCSW, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROLDAN-MARSH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:347-746-3708
Mailing Address - Street 1:32A FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH LYNBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11563-1227
Mailing Address - Country:US
Mailing Address - Phone:347-746-3708
Mailing Address - Fax:
Practice Address - Street 1:7 FRANKLIN AVENUE
Practice Address - Street 2:
Practice Address - City:NORTH LYNBROOK
Practice Address - State:NY
Practice Address - Zip Code:11563
Practice Address - Country:US
Practice Address - Phone:347-746-3708
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1184389488OtherINDIVIDUAL NPI