Provider Demographics
NPI:1518840495
Name:MINDFUL JOURNEY NETWORK PLLC
Entity type:Organization
Organization Name:MINDFUL JOURNEY NETWORK PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALEXIS
Authorized Official - Middle Name:BRIANNA
Authorized Official - Last Name:LOWE SURRATT
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHC
Authorized Official - Phone:704-914-7121
Mailing Address - Street 1:10926 DAVID TAYLOR DR.
Mailing Address - Street 2:STE 120 PMB460
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262
Mailing Address - Country:US
Mailing Address - Phone:704-914-7121
Mailing Address - Fax:
Practice Address - Street 1:5845 COUGAR LN
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-1554
Practice Address - Country:US
Practice Address - Phone:704-914-7121
Practice Address - Fax:704-353-7040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-29
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health