MEDICARE: MINDY, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1154252633
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MINDY, LLC

Provider Business Mailing Address
First Line	:	PO BOX 79
Second Line	:
City	:	TAOS SKI VALLEY
State	:	NM
Zip	:	87525-0079
Country	:	US
Telephone Number	:	917-447-0692
Fax Number	:

Provider Business Practice Location Address
First Line	:	3 CAMINO CUERVO
Second Line	:
City	:	EL PRADO
State	:	NM
Zip	:	87529-4421
Country	:	US
Telephone Number	:	917-447-0692
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. MINDY ANN JONES
Credential	:	LLC
Telephone Number	:	917-447-0692

Provider Enumeration Date	:	05/26/2026
Last Update Date	:	05/26/2026

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