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NPI Code Detail

MEDICARE: MINDFULL HEALING LLC

MEDICARE: MINDFULL HEALING 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
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1356106785
Entity Type Code : Organization
Provider Name (Legal Business Name) : MINDFULL HEALING LLC
Provider Business Mailing Address
First Line : 8914 STONE GREEN WAY
Second Line :
City : LOUISVILLE
State : KY
Zip : 40220-4072
Country : US
Telephone Number : 502-741-4967
Fax Number :
Provider Business Practice Location Address
First Line : 8914 STONE GREEN WAY
Second Line :
City : LOUISVILLE
State : KY
Zip : 40220-4072
Country : US
Telephone Number : 502-741-4967
Fax Number :
Authorized Official
Title or Position : CREDENTIALING ADMIN
Name : JACQUELINE SANDERS
Credential :
Telephone Number : 502-200-3550
Provider Enumeration Date : 02/15/2024
Last Update Date : 03/11/2025

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Directions to “MINDFULL HEALING LLC ” Practice Location

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