MINDFUL MOUNTAIN WELLNESS CENTER NPI 1083453161

NPI Information

  • NPI: 1083453161
  • Provider Name: MINDFUL MOUNTAIN WELLNESS CENTER
  • Classification: Psychiatry & Neurology - 2084P0804X
  • Specialization: Child & Adolescent Psychiatry
  • Entity Type: Organization
  • Address: 2014 MEMORIAL AVE SW
    ROANOKE, VA
    ZIP 24015
  • Phone: (540) 750-4996

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NPI Details

MINDFUL MOUNTAIN WELLNESS CENTER is a child and adolescent psychiatry psychiatry neurology in Roanoke, VA. The provider is child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. MINDFUL MOUNTAIN WELLNESS CENTER NPI is 1083453161. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2014 MEMORIAL AVE SW
ROANOKE, VA
ZIP 24015-032
Phone: (540) 750-4996

The provider's authorized official is Ryan Matthew White .
The authorized official title is Psychiatrist and has the following contact phone number (210) 315-5629.

The enumeration date for this NPI number is 5/20/2024 and was last updated on 7/15/2024.

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
11041C0700XSocial WorkerClinicalNo
22084P0804XPsychiatry & NeurologyChild & Adolescent PsychiatryYes

What is NPI?

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

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