Provider Demographics
NPI:1245830363
Name:MINDFUL RESOLUTIONS PSYCHOTHERAPEUTIC SERVICES LLC
Entity type:Organization
Organization Name:MINDFUL RESOLUTIONS PSYCHOTHERAPEUTIC SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:MIGENES
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:203-220-9770
Mailing Address - Street 1:193 WESTPORT RD
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:CT
Mailing Address - Zip Code:06612-1329
Mailing Address - Country:US
Mailing Address - Phone:203-220-9770
Mailing Address - Fax:203-220-9771
Practice Address - Street 1:193 WESTPORT RD
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:CT
Practice Address - Zip Code:06612-1329
Practice Address - Country:US
Practice Address - Phone:203-220-9770
Practice Address - Fax:203-220-9771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-28
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty