Provider Demographics
NPI:1801368055
Name:MINDFULNESS THERAPY LLC
Entity Type:Organization
Organization Name:MINDFULNESS THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:CORRADO
Authorized Official - Suffix:
Authorized Official - Credentials:LCISW
Authorized Official - Phone:302-723-2855
Mailing Address - Street 1:820 FORKY FARM RD
Mailing Address - Street 2:
Mailing Address - City:BRUCETON MILLS
Mailing Address - State:WV
Mailing Address - Zip Code:26525-6502
Mailing Address - Country:US
Mailing Address - Phone:302-723-2855
Mailing Address - Fax:
Practice Address - Street 1:820 FORKY FARM RD
Practice Address - Street 2:
Practice Address - City:BRUCETON MILLS
Practice Address - State:WV
Practice Address - Zip Code:26525-6502
Practice Address - Country:US
Practice Address - Phone:302-723-2855
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-28
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty