MINDFUL MEDIATION LLC (NPI# 1891153474) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891153474 |
| Entity Type | Organization |
| Organization Name | MINDFUL MEDIATION LLC |
| Practice Address |
85 State St Ste D North Haven CT 06473-2240 |
| Mailing Address |
49 Englewood Dr New Haven CT 06515-2309 |
| Practice Telephone | 2033760220 |
| Enumeration Date | 2016-02-10 |
| Last Update Date | 2016-02-10 |
| Authorized Official Name | SHALYN ROSE (OWNER) |
| Authorized Official Telephone | 2033760220 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YP2500X |
Counselor Specialization: Professional |
001770 | CT | Behavioral Health & Social Service Providers |
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
008003 | CT | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 008041822 | 05 | |
| CT | 008038021 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | MINDFUL MEDIATION LLC | 9 Royden Road, Tenafly, New Jersey 07670 |
| Connecticut Business Registrations | MINDFUL MEDIATION LLC | 85 D State Street, North Haven, CT 06473 |
| Street Address |
85 STATE ST STE D |
| City | NORTH HAVEN |
| State | CT |
| Zip Code | 06473-2240 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750908604 | Carsin Marie Conner | Counselor | 85 State St Ste D, North Haven, CT 06473-2240 | 2020-06-26 |
| 1407329998 | Christine Lorraine Meyer | Counselor | 85 State St Ste D, North Haven, CT 06473-2240 | 2019-01-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043823347 | Yunmin Chen | Nurse Practitioner | 269 Spring Rd, North Haven, CT 06473 | 2020-08-26 |
| 1467944884 | Julian Cano | Acupuncturist | 444b Washington Ave, North Haven, CT 06473 | 2018-06-01 |
| 1487195848 | Wigtowne | Durable Medical Equipment & Medical Supplies | 117 Washington Ave., North Haven Shopping Cntr, North Haven, CT 06473 | 2017-03-17 |
| 1528415205 | Laura Michelle Delucia | Social Worker | 451 State St., North Haven, CT 06473 | 2016-05-23 |
| 1356702153 | Technical Gas Products, Inc. | Durable Medical Equipment & Medical Supplies | 1510 Canton Center Dr, Baltimore, MD 06473 | 2016-03-08 |
| 1043600687 | John Maltagliati | Pharmacy Technician | 200 Universal Dr. North, North Haven, CT 06473 | 2015-02-04 |
| 1184025603 | Hollyann C Mcnabola | Social Worker | 130 Washington Avenue, Upper Level, North Haven, CT 06473 | 2014-09-16 |
| 1194136648 | Carol Hogan | Speech-Language Pathologist | 54 Potter Rd, North Haven, CT 06473 | 2014-05-17 |
| 1376961946 | Jared R Langerman | Otolaryngology | 31 Broadway Fl 2, North Haven, CT 06473 | 2014-04-01 |
| 1396174280 | Azeez O Oladejo | Pharmacist | 2 Universal Drive North, North Haven, CT 06473 | 2013-11-01 |
| Find all providers in zip 06473 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700407764 | Nathan Lorenzo Smith | Social Worker | 100 State St Apt 148, North Haven, CT 06473-2227 | 2020-04-30 |
| 1053952564 | Jennifer Denise Gilliard | Social Worker | 295 Mill Rd, North Haven, CT 06473-3462 | 2019-10-05 |
| 1841774254 | Shane Michael Mahon | Social Worker | 262 State St Ste C, North Haven, CT 06473-2273 | 2018-09-20 |
| 1528544194 | Cosey Beach Counseling Pllc | Social Worker | 451 State St # A2, North Haven, CT 06473-3070 | 2018-07-17 |
| 1477079499 | Louis D'amora | Social Worker | 57 Clark Ave, North Haven, CT 06473-3603 | 2017-08-22 |
| 1245789304 | Ashley Bureau | Social Worker | 187 Quinnipiac Ave Fl 1, North Haven, CT 06473-3623 | 2016-09-29 |
| 1386023323 | Suzanne Tyghter | Social Worker | 48 Lawncrest Dr, North Haven, CT 06473-1130 | 2015-05-22 |
| 1417335191 | Danielle Meagh-knauft | Social Worker | 24 Mountain View Ter, North Haven, CT 06473-4427 | 2015-05-13 |
| 1033514112 | Kathryn Mcgibbon | Social Worker | 54 Buell St, North Haven, CT 06473-4311 | 2014-10-30 |
| 1184025603 | Hollyann C Mcnabola | Social Worker | 130 Washington Avenue, Upper Level, North Haven, CT 06473 | 2014-09-16 |
| Find all providers in NORTH HAVEN | ||||
| City | NORTH HAVEN |
| Zip Code | 06473 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.