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Organization
MINDFULLY, LLC
Active
Organization
MINDFULLY, LLC
Active
Parent organization
MINDFULLY, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MINDFULLY, LLC
Authorized official
CHARLES K ROBERTS EDD, LPCC-S, LICDC-C (AUTHORIZED OFFICIAL)
(888) 830-0347
Entity
Organization
Contact information
Practice address
4380 S SYRACUSE ST STE 320, DENVER, CO 80237-2420
(720) 526-8102
(513) 939-0310
Mailing address
1251 NILLES RD STE 5, FAIRFIELD, OH 45014-7205
(888) 830-0347
(513) 939-0310
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
171M00000X
Case Manager/Care Coordinator
—
—
175T00000X
Peer Specialist
—
—
Other
Enumeration date
04/18/2022
Last updated
08/06/2024
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