Provider Demographics
NPI:1508611690
Name:MINDFUL LIFE, LLC
Entity Type:Organization
Organization Name:MINDFUL LIFE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:DESTINI
Authorized Official - Middle Name:
Authorized Official - Last Name:NAPIER
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:812-595-9349
Mailing Address - Street 1:5936 JUNIPER RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CHARLESTOWN
Mailing Address - State:IN
Mailing Address - Zip Code:47111-8646
Mailing Address - Country:US
Mailing Address - Phone:812-595-9349
Mailing Address - Fax:812-717-3658
Practice Address - Street 1:3117 N TERRY RD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:IN
Practice Address - Zip Code:47102-8560
Practice Address - Country:US
Practice Address - Phone:812-595-9349
Practice Address - Fax:812-717-3658
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-22
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty