Provider Demographics
NPI:1790315521
Name:MINDFUL DIRECTION COUNSELING LLC
Entity Type:Organization
Organization Name:MINDFUL DIRECTION COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JO
Authorized Official - Middle Name:
Authorized Official - Last Name:MEYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-506-6565
Mailing Address - Street 1:6717 LITTLE HEMLOCK ST
Mailing Address - Street 2:
Mailing Address - City:CANADIAN LAKES
Mailing Address - State:MI
Mailing Address - Zip Code:49346-9391
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6718 9 MILE RD
Practice Address - Street 2:
Practice Address - City:MECOSTA
Practice Address - State:MI
Practice Address - Zip Code:49332-9703
Practice Address - Country:US
Practice Address - Phone:989-506-6565
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-21
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty