Provider Demographics
NPI:1366183600
Name:MINDFUL HEALTH AND HEALING THERAPY SERVICES PLLC
Entity type:Organization
Organization Name:MINDFUL HEALTH AND HEALING THERAPY SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:L
Authorized Official - Last Name:RATLEDGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-682-5896
Mailing Address - Street 1:2910 KENSINGTON ST
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:TN
Mailing Address - Zip Code:37303-5022
Mailing Address - Country:US
Mailing Address - Phone:423-436-9642
Mailing Address - Fax:
Practice Address - Street 1:2910 KENSINGTON ST
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:TN
Practice Address - Zip Code:37303-5022
Practice Address - Country:US
Practice Address - Phone:423-436-9642
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-01
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Single Specialty