Provider Demographics
NPI:1801656020
Name:MINDFUL HEALING PSYCHOTHERAPY CLINIC
Entity type:Organization
Organization Name:MINDFUL HEALING PSYCHOTHERAPY CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSCOLOGY
Authorized Official - Prefix:
Authorized Official - First Name:ANA
Authorized Official - Middle Name:
Authorized Official - Last Name:CONCEPCION CARRERO
Authorized Official - Suffix:
Authorized Official - Credentials:DRA
Authorized Official - Phone:787-487-9086
Mailing Address - Street 1:URB FLAMBOYANES 39
Mailing Address - Street 2:
Mailing Address - City:AGUADA
Mailing Address - State:PR
Mailing Address - Zip Code:00602
Mailing Address - Country:US
Mailing Address - Phone:787-487-9086
Mailing Address - Fax:
Practice Address - Street 1:AGUADA COMPLEX SUITE 5
Practice Address - Street 2:CARRETERA 115
Practice Address - City:AGUADA
Practice Address - State:PR
Practice Address - Zip Code:00602
Practice Address - Country:US
Practice Address - Phone:787-487-9086
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-22
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty