MINDFUL HEALING BEHAVIORAL & WELLNESS CLINIC LLC NPI 1003767203

NPI Information

  • NPI: 1003767203
  • Provider Name: MINDFUL HEALING BEHAVIORAL & WELLNESS CLINIC, LLC
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Organization
  • Address: 15900 W 10 MILE RD STE 211-1034
    SOUTHFIELD, MI
    ZIP 48075
  • Phone: (586) 436-7229

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NPI Details

MINDFUL HEALING BEHAVIORAL & WELLNESS CLINIC, LLC is a psychiatric/mental health nurse practitioner in Southfield, MI. MINDFUL HEALING BEHAVIORAL & WELLNESS CLINIC, LLC NPI is 1003767203. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

15900 W 10 MILE RD STE 211-1034
SOUTHFIELD, MI
ZIP 48075-036
Phone: (586) 436-7229

The provider's authorized official is Porsche M Banks .
The authorized official title is Nurse Practitioner and has the following contact phone number (586) 436-7229.

The enumeration date for this NPI number is 2/4/2026 and was last updated on 2/4/2026.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP0808XNurse PractitionerPsychiatric/Mental HealthYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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