Provider Demographics
NPI:1790474666
Name:MINDFUL INNOVATIONS COUNSELING, LLC
Entity Type:Organization
Organization Name:MINDFUL INNOVATIONS COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:B
Authorized Official - Last Name:PLATTEN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:317-409-1057
Mailing Address - Street 1:6319 E US HIGHWAY 36 STE 109
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:IN
Mailing Address - Zip Code:46123-6209
Mailing Address - Country:US
Mailing Address - Phone:317-409-1057
Mailing Address - Fax:
Practice Address - Street 1:6319 E US HIGHWAY 36 STE 109
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:IN
Practice Address - Zip Code:46123-6209
Practice Address - Country:US
Practice Address - Phone:317-409-1057
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-05
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty