Provider Demographics
NPI:1649978982
Name:MINDFUL HEALING AND WELLNESS LLC
Entity type:Organization
Organization Name:MINDFUL HEALING AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIC NURSE PRACTITIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:HERBERT
Authorized Official - Middle Name:C
Authorized Official - Last Name:RAASCH
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, APNP, PMHNP-BC
Authorized Official - Phone:262-282-3253
Mailing Address - Street 1:4915 S HOWELL AVE STE 503
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53207-5939
Mailing Address - Country:US
Mailing Address - Phone:262-282-3253
Mailing Address - Fax:414-212-8988
Practice Address - Street 1:4915 S HOWELL AVE STE 503
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53207-5939
Practice Address - Country:US
Practice Address - Phone:262-282-3253
Practice Address - Fax:414-212-8988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-16
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty