Mindful Matters Counseling, LLC
Organization Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · Stafford Springs, CT
NPI 1972079796 · NPPES record last updated Oct 18, 2018
Key facts
- NPI
- 1972079796
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
- Legal business name
- MINDFUL MATTERS COUNSELING, LLC
- Practice address
- 5 Magauran Dr
Stafford Springs, CT 06076-4037 - Phone
- (860) 712-8165
- NPI assigned
- Oct 18, 2018
- Organization subpart
- No
Authorized official
- Name
- Mrs. Shannon Laurie Radlo, LCSW
- Title
- Licensed Clinical Social Worker
- Phone
- (860) 712-8165
Practitioners 1
-
Shannon L Radlo, LCSW
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20181119001559 | CT | Part B Supplier - Clinic/Group Practice | 7214281831 |
Receives reassigned benefits from 1 practitioner Practice locations: Coventry, CT |
National Provider Directory
Locations
5 Magauran Dr
Stafford Springs, CT 06076
Phone (860) 712-8165
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | Yes |
Addresses
Primary practice location
5 Magauran Dr
Stafford Springs, CT 06076-4037
Mailing address
5 Magauran Dr
Stafford Springs, CT 06076-4037
Phone (860) 712-8165
Other names
- Mindful Matters Counseling
Other providers in Stafford Springs, CT
- Christine Malcolm
- Holly Margaret Marek
- Martha Abromaitis Dba Stafford Physical Therapy
- Kate B Mastronunzio
- Megan McCollum
- Chloe Molitoris
- Nes Medical Services of Northern Connecticut, P.C.
- Nutmeg Healthcare Associates, P.C.
- Holly Ortiz
- Julia Paakkonen
All providers in Stafford Springs, CT · Mental Health Clinic/Center (Including Community Mental Health Center) in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 18, 2018. 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.