Healthcare Provider Details

I. General information

NPI: 1912892746
Provider Name (Legal Business Name): MINDFUL HEALTH CONSULTING AND THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2025
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 MESSENGER ST
SAINT ALBANS VT
05478-1546
US

IV. Provider business mailing address

18 MESSENGER ST
SAINT ALBANS VT
05478-1546
US

V. Phone/Fax

Practice location:
  • Phone: 802-922-5919
  • Fax:
Mailing address:
  • Phone: 802-922-5919
  • 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: KEVIN J KING
Title or Position: COUNSELOR
Credential: LICSW
Phone: 802-922-5919