MEDICARE: MINDFUL MENTAL HEALTH, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1083285787
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MINDFUL MENTAL HEALTH, PLLC

Provider Business Mailing Address
First Line	:	2922 WHETROCK LN
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-1737
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2922 WHETROCK LN
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-1737
Country	:	US
Telephone Number	:	281-789-3089
Fax Number	:

Authorized Official
Title or Position	:	OWNER/FOUNDER
Name	:	EMILY SCHWASS
Credential	:
Telephone Number	:	281-789-3089

Provider Enumeration Date	:	07/05/2021
Last Update Date	:	07/05/2021

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