Healthcare Provider Details

I. General information

NPI: 1275471542
Provider Name (Legal Business Name): MINDFUL CONNECTIONS BEHAVIORAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

531 S US HIGHWAY 1 STE A2
FORT PIERCE FL
34950-8317
US

IV. Provider business mailing address

531 S US HIGHWAY 1 STE A2
FORT PIERCE FL
34950-8317
US

V. Phone/Fax

Practice location:
  • Phone: 786-566-5929
  • Fax:
Mailing address:
  • Phone: 772-577-2183
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: YAIMA HERNANDEZ
Title or Position: OWNER
Credential:
Phone: 772-577-2183