Healthcare Provider Details

I. General information

NPI: 1295699189
Provider Name (Legal Business Name): MINDFUL GROWTH WITH MARIA LCSW, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 11/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

307 WEST 36TH STREET,16TH FLOOR
NEW YORK NY
10018
US

IV. Provider business mailing address

307 W 38TH ST FL 16
NEW YORK NY
10018-9514
US

V. Phone/Fax

Practice location:
  • Phone: 929-376-9330
  • Fax:
Mailing address:
  • Phone: 929-376-9330
  • 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: MARIA ORTIZ
Title or Position: OWNER
Credential: LCSW
Phone: 929-376-9330