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General NPI Number Information
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NPI Number | 1114801412
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Entity Type | Organization
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Legal Business Name | MINDFUL FOOTING PLLC
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Dates
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Enumeration Date | 08/01/2025
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Last Update Date | 08/01/2025
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Provider Practice Location Address
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Address Line | 6985 NEXUS CT STE 107
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City | FAYETTEVILLE
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State | NC
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Zip | 28304-3186
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Country | US
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Telephone | 910-760-4836
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Fax |
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Provider Business Mailing Address
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Address Line | 147 SHEPARD DR
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City | LINDEN
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State | NC
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Zip | 28356-9590
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Country | US
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Telephone | 919-591-6560
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Fax |
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Authorized Official
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Title or Position | OWNER/ LCMHCA
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Name | DANA WASHINGTON
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Credential |
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Telephone | 919-591-6560
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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