MEDICARE: MINDFUL HEALING & WELLNESS PLLC

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1942085543
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MINDFUL HEALING & WELLNESS PLLC

Provider Business Mailing Address
First Line	:	22427 CLAIRWOOD ST
Second Line	:
City	:	SAINT CLAIR SHORES
State	:	MI
Zip	:	48080-1943
Country	:	US
Telephone Number	:	586-914-0342
Fax Number	:

Provider Business Practice Location Address
First Line	:	333 W 7TH ST STE 170
Second Line	:
City	:	ROYAL OAK
State	:	MI
Zip	:	48067-2510
Country	:	US
Telephone Number	:	810-279-0501
Fax Number	:

Authorized Official
Title or Position	:	PSYCHOTHERAPIST
Name	:	BLAINA GABRIELLE MORGAN
Credential	:	LMSW
Telephone Number	:	810-279-0501

Provider Enumeration Date	:	08/30/2023
Last Update Date	:	09/02/2025

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