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General NPI Number Information
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NPI Number | 1619838547
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Entity Type | Organization
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Legal Business Name | THE MINDFUL WILLOW, LLC
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Dates
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Enumeration Date | 11/20/2025
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Last Update Date | 11/20/2025
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Provider Practice Location Address
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Address Line | 127 E MAIN ST STE 104
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City | CRAWFORDSVILLE
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State | IN
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Zip | 47933-1711
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Country | US
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Telephone | 765-754-4095
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Fax | 765-356-9694
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Provider Business Mailing Address
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Address Line | 1777 N OLD STATE ROAD 55
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City | CRAWFORDSVILLE
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State | IN
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Zip | 47933-8105
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Country | US
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Telephone | 765-918-7294
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Fax | 765-356-9694
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Authorized Official
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Title or Position | PMHNP
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Name | LINDSEY CORD
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Credential | PMHNP-BC
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Telephone | 765-918-7294
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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