Mindfully Restored, LLC

NPI #1013653237 in Glendale, New York

Provider Information

NPI Number: 1013653237
Entity Type: Organization
Organization Name: Mindfully Restored, LLC
Primary Specialty: Social Worker - Clinical
Enumeration Date: May 10, 2022
Last Updated: May 10, 2022

Practice Location

Address: 7835 74TH ST FL 2
City: Glendale
State: New York
ZIP Code: 11385-7427
Phone: (929) 277-7184

Authorized Official

Name: CHANELLE SPENCER, LCSW
Title: OWNER
Phone: (929) 277-7184

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X
Counselor - Mental Health — Mental Health	101YM0800X
Counselor - Professional — Professional	101YP2500X
Counselor - School — School	101YS0200X
Social Worker	104100000X
Social Worker - School — School	1041S0200X
Marriage & Family Therapist	106H00000X
Social Worker - Clinical — Clinical	1041C0700X	Primary

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