=====================================================
General NPI Number Information
=====================================================
NPI Number | 1124955331
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THERAPY MINDSET
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/04/2026
-----------------------------------------------------
Last Update Date | 05/04/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6 TULIP DR APT 3C
-----------------------------------------------------
City | FORDS
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08863-1138
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-259-6673
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6 TULIP DR APT 3C
-----------------------------------------------------
City | FORDS
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08863-1138
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-259-6673
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MRS. MALIKA BOLA
-----------------------------------------------------
Credential | LPC, CCS, ACS
-----------------------------------------------------
Telephone | 973-259-6673
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------