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MINDFUL BEHAVIORAL INC NPI 1619241288


NPI Information

NPI: 1619241288
Provider Name: MINDFUL BEHAVIORAL, INC
Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization
Address:
2712 MIDDLEBURG DR
SUITE 105
COLUMBIA, SC
ZIP 29204
Phone: (803) 569-1789
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MINDFUL BEHAVIORAL, INC is a community behavioral health in Columbia, SC. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. MINDFUL BEHAVIORAL, INC NPI is 1619241288. The provider is registered as an organization entity type.

The provider's business location address is:

2712 MIDDLEBURG DR
SUITE 105
COLUMBIA, SC
ZIP 29204-415
Phone: (803) 569-1789
Fax: (803) 462-4972

The provider's authorized official is Akila Proctor .
The authorized official title is Owner and has the following contact phone number (919) 697-0767.

The enumeration date for this NPI number is 2/29/2012 and was last updated on 1/27/2016.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1251S00000XCommunity/Behavioral HealthSOUTH CAROLINAYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1F027MEDICARE UPINSOUTH CAROLINA
2GP5981MEDICAIDSOUTH CAROLINA

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: 4/28/2024

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