Provider Demographics
NPI:1023833845
Name:FLOURISHING MINDS THERAPY AND COACHING LLC
Entity type:Organization
Organization Name:FLOURISHING MINDS THERAPY AND COACHING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LMFT
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:
Authorized Official - Last Name:KAELIN
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:203-751-1188
Mailing Address - Street 1:207 BROADWAY APT 201
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:RI
Mailing Address - Zip Code:02840-2610
Mailing Address - Country:US
Mailing Address - Phone:203-751-1188
Mailing Address - Fax:401-247-8379
Practice Address - Street 1:650 TEN ROD RD
Practice Address - Street 2:
Practice Address - City:NORTH KINGSTOWN
Practice Address - State:RI
Practice Address - Zip Code:02852-4238
Practice Address - Country:US
Practice Address - Phone:401-684-0529
Practice Address - Fax:401-247-8379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty