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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 (PRESIDENT)
(513) 939-0300
Entity
Organization

Contact information

Practice address
333 N ALABAMA ST STE 350, INDIANAPOLIS, IN 46204-2275
(888) 830-0347
Mailing address
1251 NILLES RD STE 5, FAIRFIELD, OH 45014-7205
(888) 830-0347

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YP2500X
Professional Counselor
1041C0700X
Clinical Social Worker
106H00000X
Marriage & Family Therapist

Other

Enumeration date
05/26/2022
Last updated
05/26/2022
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