Provider Demographics
NPI:1699412882
Name:MINDFUL HEALING COUNSELING AND COACHING SERVICES LLC
Entity Type:Organization
Organization Name:MINDFUL HEALING COUNSELING AND COACHING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, LEAD THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LAQUANDRA
Authorized Official - Middle Name:BANKS
Authorized Official - Last Name:HOPPER
Authorized Official - Suffix:
Authorized Official - Credentials:MA,LCMHC,LPC
Authorized Official - Phone:704-813-9027
Mailing Address - Street 1:12770 BANDERA RD APT 611
Mailing Address - Street 2:
Mailing Address - City:HELOTES
Mailing Address - State:TX
Mailing Address - Zip Code:78023-4014
Mailing Address - Country:US
Mailing Address - Phone:704-813-9027
Mailing Address - Fax:
Practice Address - Street 1:5900 BALCONES DR STE 100
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-4298
Practice Address - Country:US
Practice Address - Phone:704-813-9027
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-18
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health