Mindful Innovations LLC
Organization Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · Ruckersville, VA
NPI 1194422907 · NPPES record last updated Jun 23, 2024
Key facts
- NPI
- 1194422907
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
- Legal business name
- MINDFUL INNOVATIONS LLC
- Practice address
- 106 Vista Heights Dr
Ruckersville, VA 22968-9510 - Phone
- (804) 723-6463
- NPI assigned
- Feb 13, 2023
- Organization subpart
- No
Authorized official
- Name
- William Ryan McCoull
- Title
- Owner
- Phone
- (804) 920-6450
Practitioners 3
-
William Ryan McCoull, LPC, LSATP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240917000477 | VA | Part B Supplier - Clinic/Group Practice | 6305387499 |
Receives reassigned benefits from 3 practitioners Practice locations: Ruckersville, VA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | Yes |
Addresses
Primary practice location
106 Vista Heights Dr
Ruckersville, VA 22968-9510
Mailing address
106 Vista Heights Dr
Ruckersville, VA 22968-9510
Phone (804) 723-6463
Other providers in Ruckersville, VA
- Kayla Marie Magnone
- Carla Mangine
- William Ryan McCoull
- Melanie E. Canada
- Cory Merva
- Dannette Nichelle Morris
- Kelsey Morris
- Natalie L Murphy
- Crystal D Myers
- Cynthia Falk Napier
All providers in Ruckersville, VA · Mental Health Clinic/Center (Including Community Mental Health Center) in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 23, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.