Provider Demographics
NPI:1871342246
Name:MINDFUL INSIGHTS MENTAL HEALTH COUNSELING PLLC
Entity type:Organization
Organization Name:MINDFUL INSIGHTS MENTAL HEALTH COUNSELING PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:MEJIA
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, C-PD, CCTP II
Authorized Official - Phone:646-907-9239
Mailing Address - Street 1:1310 HAMILTON AVE
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06706-2307
Mailing Address - Country:US
Mailing Address - Phone:917-444-6846
Mailing Address - Fax:
Practice Address - Street 1:418 BROADWAY STE Y
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12207-2922
Practice Address - Country:US
Practice Address - Phone:646-907-9239
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-16
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty