Provider Demographics
NPI:1922628924
Name:MAITRI MINDFULNESS INC.
Entity Type:Organization
Organization Name:MAITRI MINDFULNESS INC.
Other - Org Name:SOMATIC THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:STUART
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:406-548-5908
Mailing Address - Street 1:3731 EQUESTRIAN LN APT 105
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-5660
Mailing Address - Country:US
Mailing Address - Phone:406-548-5908
Mailing Address - Fax:
Practice Address - Street 1:3731 EQUESTRIAN LN APT 105
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-5660
Practice Address - Country:US
Practice Address - Phone:406-548-5908
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-20
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty