Organization
MINDFUL MOUNTAIN WELLNESS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RYAN MATTHEW WHITE DO (PSYCHIATRIST)
(210) 315-5629
Entity
Organization
Contact information
Practice address
3140 CHAPARRAL DR STE 109C, ROANOKE, VA 24018-4355
(540) 792-3872
(540) 767-6555
Mailing address
3140 CHAPARRAL DR STE 109C, ROANOKE, VA 24018-4355
(540) 792-3872
(540) 767-6555
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
—
—
Other
Enumeration date
05/20/2024
Last updated
02/02/2026
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