Healthcare Provider Details

I. General information

NPI: 1760346365
Provider Name (Legal Business Name): MINDFUL MENTAL WELLNESS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2025
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 MADISON AVE STE 400
MORRISTOWN NJ
07960-7397
US

IV. Provider business mailing address

548 MARKET ST
SAN FRANCISCO CA
94104-5401
US

V. Phone/Fax

Practice location:
  • Phone: 408-703-7926
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: LYNN BUCHANAN
Title or Position: PRESIDENT
Credential: DO
Phone: 408-703-7926