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Organization

A MINDFUL LIFE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
COLLEEN JORDON LCSW-C (OWNER)
(301) 758-7038
Entity
Organization

Contact information

Practice address
15 S ROBINSON ST, BALTIMORE, MD 21224-2256
(301) 758-7038
Mailing address
15 S ROBINSON ST, BALTIMORE, MD 21224-2256
(301) 758-7038

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
14301
SOCIAL WORK LICENSE
MD
Enumeration date
01/12/2023
Last updated
01/12/2023
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