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Contact Information

A MINDFUL SPACE THERAPY AND COACHING PLLC
1476 N 3039TH RD
OTTAWA, IL61350-9032
 Phone: 815-324-2750
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

1041C0700X 80 Licensed Clinical Social Worker
Indicates primary specialty

NPI Profile & details for A MINDFUL SPACE THERAPY AND COACHING PLLC · (Female)

NPI Number 1487528964
Status Active
Credentials
Entity Individual
Enumeration date 09/30/2025
Last updated 12/09/2025 - About 6 months ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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