| Mindful Therapy Studio Llc | |
|
11 Wildwood Medical Center Essex CT 06426 | |
| (860) 967-8941 | |
| Not Available |
| Full Name | Mindful Therapy Studio Llc |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 11 Wildwood Medical Center, Essex, Connecticut |
| Authorized Official Name and Position | Lisa Beth Rogers (OWNER) |
| Authorized Official Contact | 8609678941 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindful Therapy Studio Llc 29 Davidson Rd Colchester CT 06415-1601 Ph: (860) 967-8941 | Mindful Therapy Studio Llc 11 Wildwood Medical Center Essex CT 06426 Ph: (860) 967-8941 |
| NPI Number | 1295215093 |
|---|---|
| Provider Enumeration Date | 08/21/2018 |
| Last Update Date | 12/28/2024 |
| Certification Date | 12/28/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295215093 | NPI | - | NPPES |
| 1265742597 | Other | CT | NPI 1 |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | 008520 (Connecticut) | Secondary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
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