Provider Demographics
NPI:1609406792
Name:MINDFUL HEALING ARTS LLC
Entity type:Organization
Organization Name:MINDFUL HEALING ARTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ART THERAPIST AND PROF COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:TORI
Authorized Official - Middle Name:
Authorized Official - Last Name:KLINE
Authorized Official - Suffix:
Authorized Official - Credentials:MA, ATR-BC, LPC,CBIS
Authorized Official - Phone:484-212-5599
Mailing Address - Street 1:393 MERVINE ST
Mailing Address - Street 2:
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19464-2341
Mailing Address - Country:US
Mailing Address - Phone:484-505-9253
Mailing Address - Fax:
Practice Address - Street 1:393 MERVINE ST
Practice Address - Street 2:
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19464-2341
Practice Address - Country:US
Practice Address - Phone:484-212-5599
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-17
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt TherapistGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty