MEDICARE: MINDFUL HEALTH CONSULTING AND THERAPY 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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1912892746
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MINDFUL HEALTH CONSULTING AND THERAPY LLC

Provider Business Mailing Address
First Line	:	18 MESSENGER ST
Second Line	:
City	:	SAINT ALBANS
State	:	VT
Zip	:	05478-1546
Country	:	US
Telephone Number	:	802-922-5919
Fax Number	:

Provider Business Practice Location Address
First Line	:	18 MESSENGER ST
Second Line	:
City	:	SAINT ALBANS
State	:	VT
Zip	:	05478-1546
Country	:	US
Telephone Number	:	802-922-5919
Fax Number	:

Authorized Official
Title or Position	:	COUNSELOR
Name	:	KEVIN J KING
Credential	:	LICSW
Telephone Number	:	802-922-5919

Provider Enumeration Date	:	06/11/2025
Last Update Date	:	12/05/2025

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