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NPI Code Detail

MEDICARE: MINDFULSHIFT INC

MEDICARE: MINDFULSHIFT INC
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
1103TC0700XClinical Psychologist

General Provider Information

NPI Number : 1265225387
Entity Type Code : Organization
Provider Name (Legal Business Name) : MINDFULSHIFT INC
Provider Business Mailing Address
First Line : 2446 N JANSSEN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60614-2017
Country : US
Telephone Number : 312-320-4837
Fax Number :
Provider Business Practice Location Address
First Line : 645 N MICHIGAN AVE STE 803
Second Line :
City : CHICAGO
State : IL
Zip : 60611-5123
Country : US
Telephone Number : 312-320-4837
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. ARIADNA CYMET LANSKI
Credential : PSYD
Telephone Number : 312-320-4837
Provider Enumeration Date : 05/22/2025
Last Update Date : 05/22/2025

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Directions to “MINDFULSHIFT INC ” Practice Location

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