# MINDFULLY BALANCED

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

## Provider details

- **NPI number:** 1578315537
- **Authorized official:** SANDRA M CARLSON LMFT (LMFT)
- **Authorized official phone:** (760) 523-2140

## Contact information

- **Practice address:** 16195 SISKIYOU RD STE 120B, APPLE VALLEY, CA 92307-1346
- **Practice address phone:** (760) 523-2140
- **Practice address fax:** (760) 589-1454
- **Mailing address:** 15906 SILVER TIP WAY, VICTORVILLE, CA 92394-6403
- **Mailing address phone:** (760) 217-6437
- **Mailing address fax:** (760) 589-1454

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | — | NULL | Yes |
| 106H00000X | Marriage & Family Therapist | — | — | Yes |

## Other

- **Enumeration date:** 04/03/2024
- **Last updated:** 02/19/2025