Provider Demographics
NPI:1295434447
Name:MINDFUL SOLUTIONS THERAPY LLC
Entity type:Organization
Organization Name:MINDFUL SOLUTIONS THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER, CEO AND THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ORVILLE
Authorized Official - Last Name:MILCETICH-TANO
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:808-343-5590
Mailing Address - Street 1:95-632 HANILE ST.
Mailing Address - Street 2:G107
Mailing Address - City:MILILANI
Mailing Address - State:HI
Mailing Address - Zip Code:96789-2862
Mailing Address - Country:US
Mailing Address - Phone:808-343-5590
Mailing Address - Fax:
Practice Address - Street 1:95-632 HANILE ST.
Practice Address - Street 2:G107
Practice Address - City:MILILANI
Practice Address - State:HI
Practice Address - Zip Code:96789-2862
Practice Address - Country:US
Practice Address - Phone:808-343-5590
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-27
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty