Provider Demographics
NPI:1861220238
Name:MINDFUL HEALING, LLC
Entity type:Organization
Organization Name:MINDFUL HEALING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN/PMHNP/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-468-7675
Mailing Address - Street 1:353 SAW PALMETTO ST
Mailing Address - Street 2:
Mailing Address - City:YULEE
Mailing Address - State:FL
Mailing Address - Zip Code:32097-0098
Mailing Address - Country:US
Mailing Address - Phone:904-703-6261
Mailing Address - Fax:
Practice Address - Street 1:7901 4TH ST N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33702-4305
Practice Address - Country:US
Practice Address - Phone:904-468-7675
Practice Address - Fax:904-656-5094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-25
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health