Provider Demographics
NPI:1538556790
Name:MINDFUL LIVING LLC DBA TARA KAKATY
Entity type:Organization
Organization Name:MINDFUL LIVING LLC DBA TARA KAKATY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TARA
Authorized Official - Middle Name:M
Authorized Official - Last Name:KAKATY
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:732-778-1229
Mailing Address - Street 1:44 SYCAMORE AVE
Mailing Address - Street 2:SUITE 3D
Mailing Address - City:LITTLE SILVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07739-1242
Mailing Address - Country:US
Mailing Address - Phone:732-778-1229
Mailing Address - Fax:
Practice Address - Street 1:44 SYCAMORE AVE
Practice Address - Street 2:SUITE 3D
Practice Address - City:LITTLE SILVER
Practice Address - State:NJ
Practice Address - Zip Code:07739-1242
Practice Address - Country:US
Practice Address - Phone:732-778-1229
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-24
Last Update Date:2015-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ5062103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty