MEDICARE: MINDFUL BEE COUNSELING AND CONSULTATION, LLC

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	:	1407514292
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MINDFUL BEE COUNSELING AND CONSULTATION, LLC

Provider Business Mailing Address
First Line	:	120 ACKLINS CIR APT 312
Second Line	:
City	:	DAYTONA BEACH
State	:	FL
Zip	:	32119-9762
Country	:	US
Telephone Number	:	954-471-6075
Fax Number	:

Provider Business Practice Location Address
First Line	:	120 ACKLINS CIR APT 312
Second Line	:
City	:	DAYTONA BEACH
State	:	FL
Zip	:	32119-9762
Country	:	US
Telephone Number	:	954-471-6075
Fax Number	:

Authorized Official
Title or Position	:	OWNER/CLINICIAN
Name	:	LISA KOSS
Credential	:	LMHC
Telephone Number	:	954-471-6075

Provider Enumeration Date	:	11/30/2021
Last Update Date	:	12/02/2021

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