MINDFULLY, LLC

Provider Demographics

• NPI: 1972702520
• Name: MINDFULLY, LLC
• Entity Type: Organization
• Organization Name: MINDFULLY, LLC
• Other - Org Name: COMPASS POINT COUNSELING SERVICES
• Other - Org Type: Doing Business As
• Authorized Official - Title/Position: AUTHORIZED OFFICIAL
• Authorized Official - First Name: CHARLES
• Authorized Official - Middle Name: K
• Authorized Official - Last Name: ROBERTS
• Authorized Official - Phone: 513-939-0300
• Mailing Address - Street 1: 1251 NILLES RD
• Mailing Address - Street 2: STE. 5
• Mailing Address - City: FAIRFIELD
• Mailing Address - State: OH
• Mailing Address - Zip Code: 45014-7205
• Mailing Address - Country: US
• Mailing Address - Phone: 519-939-0300
• Mailing Address - Fax: 513-939-0310
• Practice Address - Street 1: 1251 NILLES RD STE 5
• Practice Address - City: FAIRFIELD
• Practice Address - State: OH
• Practice Address - Zip Code: 45014-7205
• Practice Address - Country: US
• Practice Address - Phone: 519-939-0300
• Practice Address - Fax: 513-939-0310
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2007-07-13
• Last Update Date: 2023-06-16

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization	Group
Yes	101Y00000X	Behavioral Health & Social Service Providers	Counselor		Group - Multi-Specialty
No	101YA0400X	Behavioral Health & Social Service Providers	Counselor	Addiction (Substance Use Disorder)	Group - Multi-Specialty
No	101YM0800X	Behavioral Health & Social Service Providers	Counselor	Mental Health	Group - Multi-Specialty
No	103T00000X	Behavioral Health & Social Service Providers	Psychologist		Group - Multi-Specialty
No	104100000X	Behavioral Health & Social Service Providers	Social Worker		Group - Multi-Specialty
No	106H00000X	Behavioral Health & Social Service Providers	Marriage & Family Therapist		Group - Multi-Specialty
No	171M00000X	Other Service Providers	Case Manager/Care Coordinator		Group - Multi-Specialty
No	175T00000X	Other Service Providers	Peer Specialist		Group - Multi-Specialty