# MINDFULLY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** COMPASS POINT PARTNERS IN WELLNESS, INC.
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1124747027
- **Legal business name:** COMPASS POINT PARTNERS IN WELLNESS, INC.
- **Authorized official:** CHARLES K ROBERTS (PRESIDENT)
- **Authorized official phone:** (513) 939-0300

## Contact information

- **Practice address:** 222 S MAIN ST FL 5, SALT LAKE CITY, UT 84101-2185
- **Practice address phone:** (888) 830-0347
- **Practice address fax:** (513) 939-0310
- **Mailing address:** 1251 NILLES RD STE 5, FAIRFIELD, OH 45014-7205
- **Mailing address phone:** (888) 830-0347
- **Mailing address fax:** (513) 939-0310

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | — |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | — |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |
| 1041C0700X | Clinical Social Worker | — | NULL | — |
| 1041C0700X | Clinical Social Worker | — | — | — |
| 106H00000X | Marriage & Family Therapist | — | NULL | — |
| 106H00000X | Marriage & Family Therapist | — | — | — |
| 171M00000X | Case Manager/Care Coordinator | — | NULL | — |
| 171M00000X | Case Manager/Care Coordinator | — | — | — |
| 175T00000X | Peer Specialist | — | NULL | — |
| 175T00000X | Peer Specialist | — | — | — |

## Other

- **Enumeration date:** 08/24/2022
- **Last updated:** 08/24/2022