Provider Demographics
NPI:1770078784
Name:MINDFUL HEALTH COUNSELING
Entity type:Organization
Organization Name:MINDFUL HEALTH COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:W
Authorized Official - Last Name:SCHERDT
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:808-280-3474
Mailing Address - Street 1:2200 MAIN ST STE 541
Mailing Address - Street 2:
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793-1640
Mailing Address - Country:US
Mailing Address - Phone:808-280-3474
Mailing Address - Fax:
Practice Address - Street 1:2200 MAIN ST STE 541
Practice Address - Street 2:
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-1640
Practice Address - Country:US
Practice Address - Phone:808-280-3474
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-22
Last Update Date:2018-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI0450101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty