MEDICARE: MINDFULNESS-COUNSELING 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	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1982947859
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MINDFULNESS-COUNSELING LLC

Provider Business Mailing Address
First Line	:	13940 CEDAR RD # 206
Second Line	:
City	:	UNIVERSITY HTS
State	:	OH
Zip	:	44118-3204
Country	:	US
Telephone Number	:	440-591-4366
Fax Number	:

Provider Business Practice Location Address
First Line	:	3109 MAYFIELD RD STE 204
Second Line	:
City	:	CLEVELAND HTS
State	:	OH
Zip	:	44118-1726
Country	:	US
Telephone Number	:	440-591-4366
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. KELLY MORGAN
Credential	:	LPCC
Telephone Number	:	440-591-4366

Provider Enumeration Date	:	03/29/2013
Last Update Date	:	02/22/2023

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