MEDICARE: SOUND MIND NEUROFEEDBACK & HEALING CENTER A MARRIAGE & FAMILY

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1306551312
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUND MIND NEUROFEEDBACK & HEALING CENTER A MARRIAGE & FAMILY

Provider Business Mailing Address
First Line	:	6650 FAIR OAKS BLVD # 122
Second Line	:
City	:	CARMICHAEL
State	:	CA
Zip	:	95608-4026
Country	:	US
Telephone Number	:	415-484-9894
Fax Number	:

Provider Business Practice Location Address
First Line	:	3128 O ST STE 3
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95816-6545
Country	:	US
Telephone Number	:	415-484-9894
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	BONNIE CARDELL
Credential	:	LMFT
Telephone Number	:	415-484-9894

Provider Enumeration Date	:	01/16/2023
Last Update Date	:	05/19/2026

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