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General NPI Number Information
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NPI Number | 1669972683
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Entity Type | Organization
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Legal Business Name | MINDSET LIFE LLC
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Dates
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Enumeration Date | 02/16/2018
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 33 PEARL ST
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City | ROCHESTER
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State | NY
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Zip | 14607-3532
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Country | US
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Telephone | 585-820-9151
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Fax |
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Provider Business Mailing Address
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Address Line | 33 PEARL ST
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City | ROCHESTER
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State | NY
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Zip | 14607-3532
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Country | US
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Telephone | 585-820-9151
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BENJAMIN LEE COHEN
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Credential |
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Telephone | 585-820-9151
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 006722
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 006206
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 279199
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License Number State | NY
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