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General NPI Number Information
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NPI Number | 1003765959
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Entity Type | Organization
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Legal Business Name | MINDFUL RECOVERY LLC
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Dates
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Enumeration Date | 01/23/2026
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Last Update Date | 01/23/2026
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Provider Practice Location Address
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Address Line | 300 N DAKOTA AVE STE 310
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City | SIOUX FALLS
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State | SD
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Zip | 57104-6026
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Country | US
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Telephone | 712-470-4022
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Fax |
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Provider Business Mailing Address
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Address Line | 2121 S SILVERTHORNE AVE APT 203
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City | SIOUX FALLS
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State | SD
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Zip | 57110-7689
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Country | US
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Telephone | 712-470-4022
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Fax |
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Authorized Official
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Title or Position | COUNSELOR
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Name | MARISSA KAY HASTINGS
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Credential | LPC, LAC, NCC
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Telephone | 712-470-4022
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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