Provider Demographics
NPI:1174376560
Name:MINDFUL BEHAVIORAL HEALTH LLC
Entity type:Organization
Organization Name:MINDFUL BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BEECHING
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:937-620-6779
Mailing Address - Street 1:8529 N DIXIE DR STE 350
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45414-2476
Mailing Address - Country:US
Mailing Address - Phone:937-620-6779
Mailing Address - Fax:
Practice Address - Street 1:8529 N DIXIE DR STE 350
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45414-2476
Practice Address - Country:US
Practice Address - Phone:937-620-6779
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty