Healthcare Provider Details

I. General information

NPI: 1154252633
Provider Name (Legal Business Name): MINDY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 CAMINO CUERVO
EL PRADO NM
87529-4421
US

IV. Provider business mailing address

PO BOX 79
TAOS SKI VALLEY NM
87525-0079
US

V. Phone/Fax

Practice location:
  • Phone: 917-447-0692
  • Fax:
Mailing address:
  • Phone: 917-447-0692
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MS. MINDY ANN JONES
Title or Position: OWNER
Credential: LLC
Phone: 917-447-0692