Healthcare Provider Details

I. General information

NPI: 1477464071
Provider Name (Legal Business Name): MIND AND MINGLE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

930 OLD HARMONY RD STE E
NEWARK DE
19713-4161
US

IV. Provider business mailing address

3 HARVEST TRL
NEWARK DE
19702-2313
US

V. Phone/Fax

Practice location:
  • Phone: 302-803-0183
  • Fax:
Mailing address:
  • Phone: 302-803-0183
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: JAMELA GRAVES
Title or Position: OWNER
Credential:
Phone: 302-803-0183