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General NPI Number Information
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NPI Number | 1275075053
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Entity Type | Organization
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Legal Business Name | MINDFUL MATTERS LLC
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Dates
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Enumeration Date | 11/10/2016
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Last Update Date | 11/10/2016
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Provider Practice Location Address
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Address Line | 1321 W CRAWFORD ST
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City | SALINA
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State | KS
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Zip | 67401-4573
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Country | US
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Telephone | 785-820-1305
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Fax |
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Provider Business Mailing Address
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Address Line | 1321 W CRAWFORD ST
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City | SALINA
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State | KS
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Zip | 67401-4573
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Country | US
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Telephone | 785-820-1305
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. SHAWNA MARIE BECKMAN
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Credential | LSCSW LAC RPT
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Telephone | 785-404-4994
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 4408
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License Number State | KS
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