Provider Demographics
NPI:1467327486
Name:MINDSPRING COUNSELING AND CENTER FOR DISSOCIATION
Entity type:Organization
Organization Name:MINDSPRING COUNSELING AND CENTER FOR DISSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MAYER
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:360-255-3778
Mailing Address - Street 1:103 E HOLLY ST STE 306
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-4728
Mailing Address - Country:US
Mailing Address - Phone:360-226-2572
Mailing Address - Fax:360-318-7320
Practice Address - Street 1:103 E HOLLY ST STE 306
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-4728
Practice Address - Country:US
Practice Address - Phone:360-255-3778
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-08
Last Update Date:2025-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)