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General NPI Number Information
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NPI Number | 1154191328
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Entity Type | Organization
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Legal Business Name | MINDFUL HEALING GROUP
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Dates
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Enumeration Date | 01/08/2024
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Last Update Date | 06/13/2025
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Provider Practice Location Address
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Address Line | 136 MADISON AVE
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City | NEW YORK
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State | NY
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Zip | 10016-6711
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Country | US
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Telephone | 910-818-4957
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Fax | 910-500-5238
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Provider Business Mailing Address
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Address Line | 5000 CENTRE GREEN WAY STE 500
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City | CARY
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State | NC
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Zip | 27513-5821
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Country | US
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Telephone | 910-302-6740
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Fax |
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Authorized Official
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Title or Position | COO
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Name | JERRY BELL CUNNINGHAM JR.
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Credential |
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Telephone | 910-209-4122
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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