Provider Demographics
NPI:1922817972
Name:MINDFUL HORIZONS LLC.
Entity type:Organization
Organization Name:MINDFUL HORIZONS LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MARVA
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:LCP, LICDC
Authorized Official - Phone:937-977-5255
Mailing Address - Street 1:945 RUTH AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45417-3612
Mailing Address - Country:US
Mailing Address - Phone:937-977-5255
Mailing Address - Fax:
Practice Address - Street 1:945 RUTH AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45417-3612
Practice Address - Country:US
Practice Address - Phone:937-977-5255
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-04
Last Update Date:2025-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty