MEDICARE: MINDFUL PSYCHIATRY, 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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1730034240
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MINDFUL PSYCHIATRY, LLC

Provider Business Mailing Address
First Line	:	155 GREY FOX DR
Second Line	:
City	:	CONWAY
State	:	AR
Zip	:	72034-7139
Country	:	US
Telephone Number	:	501-908-4526
Fax Number	:

Provider Business Practice Location Address
First Line	:	155 GREY FOX DR
Second Line	:
City	:	CONWAY
State	:	AR
Zip	:	72034-7139
Country	:	US
Telephone Number	:	501-908-4526
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PMHNP
Name	:	LAUREN BOWLING
Credential	:	APRN
Telephone Number	:	501-908-4526

Provider Enumeration Date	:	03/02/2026
Last Update Date	:	03/02/2026

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