Provider Demographics
NPI:1528811460
Name:MINDFUL ABUNDANCE COUNSELING LLC
Entity type:Organization
Organization Name:MINDFUL ABUNDANCE COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:ALBEIRO
Authorized Official - Last Name:CLAVIJO
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:508-494-1939
Mailing Address - Street 1:110 ARARAT ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01606-2623
Mailing Address - Country:US
Mailing Address - Phone:508-494-1939
Mailing Address - Fax:508-552-9459
Practice Address - Street 1:110 ARARAT ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01606-2623
Practice Address - Country:US
Practice Address - Phone:508-494-1939
Practice Address - Fax:508-552-9459
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-10
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty