Healthcare Provider Details

I. General information

NPI: 1932033909
Provider Name (Legal Business Name): MINDFUL THERAPY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3520 N HIGH ST
COLUMBUS OH
43214-4033
US

IV. Provider business mailing address

47 W LAKEVIEW AVE
COLUMBUS OH
43202-1001
US

V. Phone/Fax

Practice location:
  • Phone: 614-579-0754
  • Fax:
Mailing address:
  • Phone: 614-579-0754
  • 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: ELIZABETH BRODHAG
Title or Position: OWNER/THERAPIST
Credential: LISW-S
Phone: 614-579-0754