MEDICARE: MINDFUL LIFE 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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1609409325
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MINDFUL LIFE LLC

Provider Business Mailing Address
First Line	:	921 CLEARFIELD RD
Second Line	:
City	:	FENELTON
State	:	PA
Zip	:	16034-9701
Country	:	US
Telephone Number	:	724-355-1111
Fax Number	:

Provider Business Practice Location Address
First Line	:	371 N MAIN ST
Second Line	:
City	:	BUTLER
State	:	PA
Zip	:	16001-4955
Country	:	US
Telephone Number	:	724-355-1111
Fax Number	:

Authorized Official
Title or Position	:	OWNER/ THERAPIST
Name	:	MELISSA DAWN GEIBEL-MCKEE
Credential	:	L.S.W.
Telephone Number	:	724-355-1111

Provider Enumeration Date	:	02/20/2020
Last Update Date	:	07/03/2023

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Directions to “MINDFUL LIFE LLC ” Practice Location

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