MEDICARE: MINDFUL HARMONY 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
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1982445367
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MINDFUL HARMONY INC

Provider Business Mailing Address
First Line	:	22360 OVERTURE CIR
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33428-4263
Country	:	US
Telephone Number	:	561-215-9959
Fax Number	:	561-461-6238

Provider Business Practice Location Address
First Line	:	10328 BOCA ENTRADA BLVD APT 123
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33428-5801
Country	:	US
Telephone Number	:	561-215-9959
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/APRN
Name	:	COURTNEY WALTER
Credential	:	APRN
Telephone Number	:	561-215-9959

Provider Enumeration Date	:	06/01/2024
Last Update Date	:	12/03/2025

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