# MINDFUL MOUNTAIN WELLNESS CENTER

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083453161
- **Authorized official:** DR. RYAN MATTHEW WHITE DO (PSYCHIATRIST)
- **Authorized official phone:** (210) 315-5629

## Contact information

- **Practice address:** 3140 CHAPARRAL DR STE 109C, ROANOKE, VA 24018-4355
- **Practice address phone:** (540) 792-3872
- **Practice address fax:** (540) 767-6555
- **Mailing address:** 3140 CHAPARRAL DR STE 109C, ROANOKE, VA 24018-4355
- **Mailing address phone:** (540) 792-3872
- **Mailing address fax:** (540) 767-6555

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 101YP2500X | Professional Counselor | — | NULL | — |
| 101YP2500X | Professional Counselor | — | — | — |
| 1041C0700X | Clinical Social Worker | — | NULL | — |
| 1041C0700X | Clinical Social Worker | — | — | — |
| 2084P0804X | Child & Adolescent Psychiatry Physician | — | NULL | Yes |
| 2084P0804X | Child & Adolescent Psychiatry Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/20/2024
- **Last updated:** 02/02/2026