MEDICARE: MINDFLOW, 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	251S00000X	Community/Behavioral Health Agency
2	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1225780794
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MINDFLOW, LLC

Provider Business Mailing Address
First Line	:	2430 VANDERBILT BEACH RD STE 108
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34109-2654
Country	:	US
Telephone Number	:	239-287-6624
Fax Number	:

Provider Business Practice Location Address
First Line	:	3443 PINE RIDGE RD STE 101
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34109-3926
Country	:	US
Telephone Number	:	239-287-6624
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CHRISTY SHUTOK
Credential	:	LMHC
Telephone Number	:	239-287-6624

Provider Enumeration Date	:	01/25/2022
Last Update Date	:	06/08/2025

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