Organization Active NPI

Mindfully Mine Counseling Center

  • Counseling Psychologist
  • Ridgewood, NJ
National Provider Identifier
1780143693
Registry record updated Jun 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
Legal business name
MINDFULLY MINE COUNSELING CENTER
Practice address
179 S Maple Ave
Ridgewood, NJ 07450-4541
Phone
(201) 266-3087
Fax
(201) 462-3916
NPI assigned
Mar 19, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2026

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

Authorized official

Name
Dr. Andrea Gleim, PSY.D.,NPI 1568928851
Title
Founder/Clinical Director
Phone
(201) 266-3087

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC1900X Primary

Addresses

Primary practice location

179 S Maple Ave
Ridgewood, NJ 07450-4541

Mailing address

334 E Lake Rd Ste 357
Palm Harbor, FL 34685-2427
Phone (813) 536-6223

National Provider Directory

National Provider Directory

Locations

179 S Maple Ave
Ridgewood, NJ 07450
Phone (201) 444-3533

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1552953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780876800000",
    "number": "1780143693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "334 E LAKE RD STE 357",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346852427",
            "telephone_number": "813-536-6223",
            "fax_number": "813-687-7299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "179 S MAPLE AVE",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074504541",
            "telephone_number": "201-266-3087",
            "fax_number": "201-462-3916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFULLY MINE COUNSELING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-19",
        "last_updated": "2026-06-08",
        "certification_date": "2026-06-08",
        "status": "A",
        "authorized_official_last_name": "GLEIM",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "FOUNDER/CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "201-266-3087",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D.,"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2026; 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.