# MINDFUL HEALING GROUP LLC

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

## Provider details

- **NPI number:** 1619612686
- **Authorized official:** KELLY RANKIN LCSW (PRACTICE MANAGER)
- **Authorized official phone:** (703) 987-6500

## Contact information

- **Practice address:** 1485 CHAIN BRIDGE RD STE 302, MC LEAN, VA 22101-4501
- **Practice address phone:** (703) 987-6500
- **Practice address fax:** (240) 219-3138
- **Mailing address:** 8601 LARKHAVEN TER, FAIRFAX STATION, VA 22039-3313
- **Mailing address phone:** (571) 435-3334
- **Mailing address fax:** (240) 219-3138

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084P0804X | Child & Adolescent Psychiatry Physician | — | NULL | Yes |
| 2084P0804X | Child & Adolescent Psychiatry Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/03/2022
- **Last updated:** 05/03/2022