Healthcare Provider Details

I. General information

NPI: 1871405944
Provider Name (Legal Business Name): MINDFUL LIVING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4519 WOODRUFF RD STE 4
COLUMBUS GA
31904-6096
US

IV. Provider business mailing address

4519 WOODRUFF RD STE 4
COLUMBUS GA
31904-6096
US

V. Phone/Fax

Practice location:
  • Phone: 513-512-4645
  • Fax:
Mailing address:
  • Phone: 513-512-4645
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. RABIA SUBHANI
Title or Position: OWNER
Credential: PSY.D.
Phone: 513-512-4645