Healthcare Provider Details

I. General information

NPI: 1871497040
Provider Name (Legal Business Name): MINDFUL MATTERS THERAPEUTIC SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11589 CAREFREE LN
SHAWNEE OK
74804-7003
US

IV. Provider business mailing address

11589 CAREFREE LN
SHAWNEE OK
74804-7003
US

V. Phone/Fax

Practice location:
  • Phone: 405-446-1470
  • Fax:
Mailing address:
  • Phone: 405-446-1470
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: ALICIA FOLMAR
Title or Position: OWNER/OPERATOR
Credential: LMFT-S
Phone: 405-446-1470