Provider Demographics
NPI:1710755343
Name:MINDFUL MATTERS COUNSELING SERVICES
Entity Type:Organization
Organization Name:MINDFUL MATTERS COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:M
Authorized Official - Last Name:MCCOY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-S
Authorized Official - Phone:985-381-3086
Mailing Address - Street 1:229 RICHLAND DR
Mailing Address - Street 2:
Mailing Address - City:THIBODAUX
Mailing Address - State:LA
Mailing Address - Zip Code:70301-6479
Mailing Address - Country:US
Mailing Address - Phone:985-381-3086
Mailing Address - Fax:985-243-2536
Practice Address - Street 1:108 EAST 11ST
Practice Address - Street 2:
Practice Address - City:THIBODAUX
Practice Address - State:LA
Practice Address - Zip Code:70301
Practice Address - Country:US
Practice Address - Phone:985-381-3086
Practice Address - Fax:985-243-2536
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-13
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)