Provider Demographics
NPI:1447833108
Name:MINDFUL WELLNESS VI, PLLC
Entity type:Organization
Organization Name:MINDFUL WELLNESS VI, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEIRDRE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:WEST ROY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:340-201-1195
Mailing Address - Street 1:5043 NORRE GADE STE 2
Mailing Address - Street 2:
Mailing Address - City:ST THOMAS
Mailing Address - State:VI
Mailing Address - Zip Code:00802-6834
Mailing Address - Country:US
Mailing Address - Phone:340-201-1195
Mailing Address - Fax:
Practice Address - Street 1:11A NORRE GADE, SUITE 2
Practice Address - Street 2:SUITE 4
Practice Address - City:ST THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00802-0080
Practice Address - Country:US
Practice Address - Phone:340-201-1195
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-30
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)