Mindful Wellness Counseling, LLC.

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

License

CW019687 Issued in PA

Legal business name

MINDFUL WELLNESS COUNSELING, LLC.

Doing business as

Mindful Wellness Counseling, LLC.

Practice address

12869 Rennoll Rd
Glen Rock, PA 17327-8506

Phone

(301) 792-9212

NPI assigned

Mar 19, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Zoe Windham Hunter Travers, LCSW-C

Title

Owner

Phone

(301) 792-9212

Specialties & licenses 2

Addresses

Other names 1

• Mindful Wellness Counseling, LLC. Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1521417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564704000000",
    "number": "1487158200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12869 RENNOLL RD",
            "city": "GLEN ROCK",
            "state": "PA",
            "postal_code": "173278506",
            "telephone_number": "301-792-9212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12869 RENNOLL RD",
            "city": "GLEN ROCK",
            "state": "PA",
            "postal_code": "173278506",
            "telephone_number": "301-792-9212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL WELLNESS COUNSELING, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-19",
        "last_updated": "2019-08-02",
        "status": "A",
        "authorized_official_last_name": "TRAVERS",
        "authorized_official_first_name": "ZOE",
        "authorized_official_middle_name": "WINDHAM HUNTER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-792-9212",
        "authorized_official_credential": "LCSW-C"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "PA",
            "license": "CW019687",
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "MD",
            "license": "15257",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mindful Wellness Counseling, LLC.",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mindful Wellness Counseling, LLC.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Adult Mental Health Clinic/Center in Glen Rock, PA
• Providers in Glen Rock, PA by specialty
• Adult Mental Health Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.