Provider Demographics
NPI:1477381994
Name:MINDFUL HEALING COUNSELING LLC
Entity type:Organization
Organization Name:MINDFUL HEALING COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MARRIAGE AND FAMILY THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:BETANIA
Authorized Official - Middle Name:MARIE GUERRA
Authorized Official - Last Name:HARDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:608-285-2280
Mailing Address - Street 1:2858 INTERLAKEN PASS
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53719-2473
Mailing Address - Country:US
Mailing Address - Phone:619-417-6365
Mailing Address - Fax:
Practice Address - Street 1:2858 INTERLAKEN PASS
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53719-2473
Practice Address - Country:US
Practice Address - Phone:608-285-2280
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-25
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health