MINDBODYSOULWORKS, LLC (NPI# 1205309531) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205309531 |
| Entity Type | Organization |
| Organization Name | MINDBODYSOULWORKS, LLC |
| Practice Address |
4190 E Lake Rd Erie PA 16511-1355 |
| Practice Telephone | 8146162858 |
| Practice Fax Number | 8146162860 |
| Mailing Telephone | 8146162858 |
| Mailing Fax Number | 8146162860 |
| Enumeration Date | 2019-01-09 |
| Last Update Date | 2019-01-09 |
| Authorized Official Name | MARY RUDOLPH (THERAPIST/OWNER) |
| Authorized Official Telephone | 8146162858 |
| Authorized Official Credential | BSN, RN, LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| Street Address |
4190 E LAKE RD |
| City | ERIE |
| State | PA |
| Zip Code | 16511-1355 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770546376 | Steven Daniel Krauza | Chiropractor | 4190 E Lake Rd, Erie, PA 16511-1355 | 2006-04-07 |
| 1174910855 | Mary Rudolph | Counselor | 4190 E Lake Rd, Erie, PA 16511 | 2015-04-21 |
| 1962570176 | Krauza Family Chiropractic, Inc | Chiropractor | 4190 E Lake Rd, Erie, PA 16511-1355 | 2006-12-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467701359 | Debbie Marie Marche | Licensed Practical Nurse | 852 Newton Ave, Erie, PA 16511 | 2012-09-06 |
| 1164781456 | Kevin D. Deuel | Licensed Practical Nurse | 755 Napier Ave.., Erie, PA 16511 | 2012-05-08 |
| 1104827617 | William Rudolph Phelps | Surgery | 101 Walten Point, Erie, PA 16511 | 2005-08-09 |
| 1700884632 | Jennifer Amy Kilgas | Physical Therapist | Trac Rehab East, 4403 Iroguois Ave, Erie, PA 16511 | 2005-07-13 |
| 1891794699 | David Jon Markiewicz | Physical Therapist | Trac Rehab East, 4403 Iroquois Ave, Erie, PA 16511 | 2005-07-14 |
| 1699773523 | Karen Ann Zielinski | Physical Therapist | Trac Rehab East, 4403 Iroquois Ave, Erie, PA 16511 | 2005-07-13 |
| 1326151432 | East Lake Pharmacy Inc | Pharmacy | 1896 E Lake Rd, Erie, PA 16511-1072 | 2006-08-16 |
| 1497030142 | Barbara Anne Thompson | Registered Nurse | 402 Euclid Ave, Erie, PA 16511-1126 | 2011-10-13 |
| 1669821518 | Christopher Sedgwick | Pharmacist | 2684 Lakeside Dr, Erie, PA 16511-1252 | 2016-06-10 |
| 1831423136 | Keith Eller | Counselor | 212 Lowry Rd, Erie, PA 16511-1327 | 2009-09-21 |
| Find all providers in zip 16511 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376153940 | Nami Erie County Pa | Clinic/Center | 1611 Peach St Ste 218, Erie, PA 16501-2121 | 2020-08-07 |
| 1891267027 | Solace Counseling, Pllc | Clinic/Center | 671 Mitchell Way Ste 116, Erie, CO 80516-5447 | 2018-12-28 |
| 1104275841 | Erie Colorado Counseling Pllc | Clinic/Center | 685 Briggs St., Erie, CO 80516-0944 | 2016-06-03 |
| 1518506716 | Safe Harbor Behavioral Health of Upmc Hamot | Clinic/Center | 1330 W 26th St, Erie, PA 16508-1402 | 2020-01-06 |
| 1518522242 | Journey To A Trauma-informed Life | Clinic/Center | 2230 W 8th St Ste 2, Erie, PA 16505-4545 | 2019-05-08 |
| 1356811905 | Katherine N. Hoffman, Lpc | Clinic/Center | 2221 Peninsula Dr Ste 207, Erie, PA 16506-2954 | 2018-11-27 |
| 1720594724 | Family Services of Nw Pa | Clinic/Center | 5100 Peach Street, Erie, PA 16506 | 2017-12-28 |
| 1942758404 | Erie Wellness, PC | Clinic/Center | 1455 W 38th St, Erie, PA 16508-2350 | 2016-09-13 |
| 1770794208 | Safe Harbor Behavioral Health of Upmc Hamot | Clinic/Center | 1330 W 26th St, Erie, PA 16508-1402 | 2007-05-25 |
| 1164598751 | Saint Vincent Health Center | Clinic/Center | 232 W 25th St, Erie, PA 16544-0002 | 2006-11-27 |
| Find all providers in ERIE | ||||
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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.