| Mindful Mediation Llc | |
|
85 State St Ste D North Haven CT 06473-2240 | |
| (203) 376-0220 | |
| Not Available |
| Full Name | Mindful Mediation Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 85 State St Ste D, North Haven, Connecticut |
| Authorized Official Name and Position | Shalyn Rose (OWNER) |
| Authorized Official Contact | 2033760220 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindful Mediation Llc 49 Englewood Dr New Haven CT 06515-2309 Ph: () - | Mindful Mediation Llc 85 State St Ste D North Haven CT 06473-2240 Ph: (203) 376-0220 |
| NPI Number | 1891153474 |
|---|---|
| Provider Enumeration Date | 02/10/2016 |
| Last Update Date | 02/10/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891153474 | NPI | - | NPPES |
| 008041822 | Medicaid | CT | |
| 008038021 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 001770 (Connecticut) | Secondary |
| 1041C0700X | Social Worker - Clinical | 008003 (Connecticut) | Primary |
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