Provider Demographics
NPI:1740027390
Name:MINDFUL MENTAL HEALTH LLC
Entity type:Organization
Organization Name:MINDFUL MENTAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADULT GERONTOLOGY NURSE PRACTITIONE
Authorized Official - Prefix:MR
Authorized Official - First Name:COLIN
Authorized Official - Middle Name:AUSTIN
Authorized Official - Last Name:MCWILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:781-249-5960
Mailing Address - Street 1:251 TREMONT ST
Mailing Address - Street 2:
Mailing Address - City:DUXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02332-4828
Mailing Address - Country:US
Mailing Address - Phone:781-249-5960
Mailing Address - Fax:
Practice Address - Street 1:251 TREMONT ST
Practice Address - Street 2:
Practice Address - City:DUXBURY
Practice Address - State:MA
Practice Address - Zip Code:02332-4828
Practice Address - Country:US
Practice Address - Phone:781-249-5960
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-11
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty