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General NPI Number Information
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NPI Number | 1386498970
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Entity Type | Organization
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Legal Business Name | MINDFUL HEALING COUNSELING LLC
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Dates
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Enumeration Date | 04/11/2024
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Last Update Date | 10/24/2024
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Provider Practice Location Address
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Address Line | 5-4280 KUHIO HWY STE G-210C
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City | PRINCEVILLE
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State | HI
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Zip | 96722-1700
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Country | US
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Telephone | 808-635-4371
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 200
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City | KILAUEA
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State | HI
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Zip | 96754-0200
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Country | US
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Telephone | 808-635-4371
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | TEAL SARGENT
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Credential | LCSW
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Telephone | 808-635-4371
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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