| Mindful Realization Llc | |
|
160 Laurel Ave Northport NY 11768-3168 | |
| (631) 971-8772 | |
| Not Available |
| Full Name | Mindful Realization Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 160 Laurel Ave, Northport, New York |
| Authorized Official Name and Position | Caitlin Clouse (FOUNDER) |
| Authorized Official Contact | 6319718772 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindful Realization Llc 4 Haig Pl Kings Park NY 11754-5111 Ph: (631) 971-8772 | Mindful Realization Llc 160 Laurel Ave Northport NY 11768-3168 Ph: (631) 971-8772 |
| NPI Number | 1770439648 |
|---|---|
| Provider Enumeration Date | 03/04/2026 |
| Last Update Date | 03/04/2026 |
| Certification Date | 03/04/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770439648 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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