# MINDFUL THERAPY, LLC

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

## Provider details

- **NPI number:** 1467980300
- **Authorized official:** AUDREY ANN WENDT MSW, LMSW, CAADC (EXECUTIVE DIRECTOR/OWNER)
- **Authorized official phone:** (989) 388-4185

## Contact information

- **Practice address:** 122 N MAPLE ST, ITHACA, MI 48847-1024
- **Practice address phone:** (989) 388-4185
- **Practice address fax:** (989) 388-4187
- **Mailing address:** 122 N MAPLE ST, ITHACA, MI 48847-1024
- **Mailing address phone:** (989) 388-4185
- **Mailing address fax:** (989) 388-4187

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | SA0190019 | MI | — |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | SA0290035 | MI | — |
| 101YM0800X | Mental Health Counselor | SA0190019 | MI | — |
| 101YM0800X | Mental Health Counselor | SA0290035 | MI | — |
| 171M00000X | Case Manager/Care Coordinator | SA0190019 | MI | Yes |
| 171M00000X | Case Manager/Care Coordinator | SA0290035 | MI | — |

## Other

- **Enumeration date:** 05/23/2017
- **Last updated:** 09/11/2025