Provider Demographics
NPI:1487097812
Name:MINDFUL HEARTS INSTITUTE
Entity type:Organization
Organization Name:MINDFUL HEARTS INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:BURTON
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:321-388-6838
Mailing Address - Street 1:235 S MAITLAND AVE
Mailing Address - Street 2:SUITE 112
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-5677
Mailing Address - Country:US
Mailing Address - Phone:321-388-6838
Mailing Address - Fax:
Practice Address - Street 1:235 S MAITLAND AVE
Practice Address - Street 2:SUITE 112
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-5677
Practice Address - Country:US
Practice Address - Phone:321-388-6838
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-16
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH7208101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty