Organization
MINDFUL HEALTH SERVICES LLC
Active
Other names
MINDFUL HEALTH SERVICES LLC
Organization subpart
No
Provider details
NPI number
Authorized official
TRAVIS B THAME (OWNER)
(772) 812-6852
Entity
Organization
Contact information
Practice address
160 NW CENTRAL PARK PLZ STE 105, PORT ST LUCIE, FL 34986-1825
(772) 812-6852
(772) 494-7271
Mailing address
160 NW CENTRAL PARK PLZ STE 105, PORT ST LUCIE, FL 34986-1825
(772) 812-6852
(772) 494-7271
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
103G00000X
Clinical Neuropsychologist
Primary
—
—
2084P0802X
Addiction Psychiatry Physician
—
—
Other
Enumeration date
10/25/2019
Last updated
10/25/2019
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