MINDFUL REALIZATION LLC NPI 1770439648

NPI Information

  • NPI: 1770439648
  • Provider Name: MINDFUL REALIZATION LLC
  • Classification: Social Worker - 1041C0700X
  • Specialization: Clinical
  • Entity Type: Organization
  • Address: 160 LAUREL AVE
    NORTHPORT, NY
    ZIP 11768
  • Phone: (631) 971-8772

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NPI Details

MINDFUL REALIZATION LLC is a clinical social worker in Northport, NY. The provider is a social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. MINDFUL REALIZATION LLC NPI is 1770439648. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

160 LAUREL AVE
NORTHPORT, NY
ZIP 11768-168
Phone: (631) 971-8772

The provider's authorized official is Caitlin Clouse .
The authorized official title is Founder and has the following contact phone number (631) 971-8772.

The enumeration date for this NPI number is 3/4/2026 and was last updated on 3/4/2026.

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
1104100000XSocial WorkerNo
21041C0700XSocial WorkerClinicalYes

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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