Provider Demographics
NPI:1730710658
Name:MINDFUL LIVING PSYCHOLOGY SERVICES, PLLC
Entity type:Organization
Organization Name:MINDFUL LIVING PSYCHOLOGY SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICSW, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DORA OLIVIA
Authorized Official - Middle Name:
Authorized Official - Last Name:OCHOA
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:915-727-8785
Mailing Address - Street 1:2359 FRANKLIN AVE E UNIT 307
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98102-3978
Mailing Address - Country:US
Mailing Address - Phone:915-727-8785
Mailing Address - Fax:
Practice Address - Street 1:2359 FRANKLIN AVE E UNIT 307
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98102-3978
Practice Address - Country:US
Practice Address - Phone:915-727-8785
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-29
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty