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MINDFUL THERAPY STUDIO LLC NPI 1295215093


NPI Information

NPI: 1295215093
Provider Name: MINDFUL THERAPY STUDIO LLC
Classification: Clinic/Center - 261QM0855X
Entity Type: Organization

Specialization: Adolescent and Children Mental Health

Address:
16 RAE PALMER ROAD
MOODUS, CT
ZIP 06423
Phone: (860) 967-8941
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MINDFUL THERAPY STUDIO LLC is an adolescent and children mental health clinic center in Moodus, CT. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. MINDFUL THERAPY STUDIO LLC NPI is 1295215093. The provider is registered as an organization entity type.

The provider's business location address is:

16 RAE PALMER ROAD
MOODUS, CT
ZIP 06423
Phone: (860) 967-8941

The provider's authorized official is Lisa Beth Rogers .
The authorized official title is Owner and has the following contact phone number (860) 967-8941.

The enumeration date for this NPI number is 8/21/2018 and was last updated on 9/6/2018.


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
1261QM0850XClinic/CenterAdult Mental Health008520CONNECTICUTNo
2261QM0855XClinic/CenterAdolescent and Children Mental HealthYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11265742597OTHERCONNECTICUTNPI 1

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: 5/5/2024

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