Healthcare Provider Details

I. General information

NPI: 1760346829
Provider Name (Legal Business Name): MINDFUL PSYCHIATRY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2025
Last Update Date: 12/12/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 SOUTH LEXINGTON STREET STE 100
HARRISONVILLE MO
64701
US

IV. Provider business mailing address

711 SOUTH LEXINGTON STREET STE 100
HARRISONVILLE MO
64701
US

V. Phone/Fax

Practice location:
  • Phone: 417-647-4408
  • Fax: 417-304-2289
Mailing address:
  • Phone: 417-647-4408
  • Fax: 417-304-2289

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE SUE BALL
Title or Position: OWNER/PROVIDER
Credential: PMHNP-BC
Phone: 417-719-2180