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Organization

MINDFUL THERAPY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
AUDREY ANN WENDT MSW, LMSW, CAADC (EXECUTIVE DIRECTOR/OWNER)
(989) 388-4185
Entity
Organization

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
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
Primary
SA0190019
MI
171M00000X
Case Manager/Care Coordinator
SA0290035
MI

Other

Enumeration date
05/23/2017
Last updated
09/11/2025
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