| Mindful Behavioral, Inc | |
|
2712 Middleburg Dr Suite 105 Columbia SC 29204-2415 | |
| (803) 569-1789 | |
| (803) 462-4972 |
| Full Name | Mindful Behavioral, Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2712 Middleburg Dr, Columbia, South Carolina |
| Authorized Official Name and Position | Akila Proctor (OWNER) |
| Authorized Official Contact | 9196970767 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindful Behavioral, Inc 2712 Middleburg Dr Suite 105 Columbia SC 29204-2415 Ph: (803) 569-1789 | Mindful Behavioral, Inc 2712 Middleburg Dr Suite 105 Columbia SC 29204-2415 Ph: (803) 569-1789 |
| NPI Number | 1619241288 |
|---|---|
| Provider Enumeration Date | 02/29/2012 |
| Last Update Date | 01/27/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619241288 | NPI | - | NPPES |
| GP5981 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (South Carolina) | Primary |
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