Provider Demographics
NPI:1205438462
Name:MIND WELLNESS THERAPY, PLLC
Entity type:Organization
Organization Name:MIND WELLNESS THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIRSTEN
Authorized Official - Middle Name:
Authorized Official - Last Name:WOODS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:214-471-2610
Mailing Address - Street 1:15922 ELDORADO PKWY
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-5836
Mailing Address - Country:US
Mailing Address - Phone:214-702-6115
Mailing Address - Fax:
Practice Address - Street 1:11279 BLACKHAWK DR
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-7385
Practice Address - Country:US
Practice Address - Phone:214-471-2610
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-12
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty