MINDFUL THERAPY STUDIO LLC (NPI# 1295215093) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295215093 |
| Entity Type | Organization |
| Organization Name | MINDFUL THERAPY STUDIO LLC |
| Practice Address |
16 Rae Palmer Road Moodus CT 06423 |
| Mailing Address |
29 Davidson Rd Colchester CT 06415-1601 |
| Practice Telephone | 8609678941 |
| Mailing Telephone | 8609678941 |
| Enumeration Date | 2018-08-21 |
| Last Update Date | 2018-09-06 |
| Authorized Official Name | MS. LISA BETH ROGERS (OWNER) |
| Authorized Official Telephone | 8609678941 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
008520 | CT | Ambulatory Health Care Facilities |
| Y | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | NPI 1 | 1265742597 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 11 Wildwood Medical Center, Essex, CT 06426 | 8609678941 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447894209 | Mindful Therapy Studio LLC | Clinic/Center | 16 Rae Palmer Rd, Moodus, CT 06469-1195 | 2019-11-04 |
| Street Address |
16 RAE PALMER ROAD |
| City | MOODUS |
| State | CT |
| Zip Code | 06423 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063854131 | Maryla Radziszewski | Massage Therapist | 62 Creamery Rd, East Haddam, CT 06423 | 2013-07-18 |
| 1467599423 | Linda E. Ryder-munet | Marriage & Family Therapist | 41 Lookout Drive, East Haddam, CT 06423 | 2007-01-31 |
| 1801896634 | East Haddam Ambulance Assoc Inc | Ambulance | 440 Town St., East Haddam, CT 06423 | 2005-07-22 |
| 1861969685 | John Wade Candler | Radiology Practitioner Assistant | 64 Wickham Rd, East Haddam, CT 06423-1203 | 2018-10-30 |
| 1609152883 | Carol Parham | Occupational Therapist | 50b Norwich Rd, East Haddam, CT 06423-1382 | 2011-11-01 |
| 1689089260 | Melissa Lyn Wyskiel | Occupational Therapist | 534 Town St, East Haddam, CT 06423-1390 | 2014-06-23 |
| 1285706135 | Brett Ashley Helmer | Occupational Therapist | 534 Town St, East Haddam, CT 06423-1390 | 2006-11-15 |
| 1043515356 | Joshua David Acocella-stollerman | Psychologist | 140 River Rd, East Haddam, CT 06423-1403 | 2011-01-18 |
| 1043548837 | Diane Kaemmer | Dietitian, Registered | 135 Town St, East Haddam, CT 06423-1458 | 2009-12-07 |
| 1417410028 | Michael Anthony Seaver | Counselor | 279 Mount Parnassus Rd, East Haddam, CT 06423-1527 | 2019-04-10 |
| Find all providers in zip 06423 | ||||
| Taxonomy Code | 261QM0855X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adolescent and Children Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780195339 | Rachel Collins, Lpc | Clinic/Center | 410 State St Rm 1, North Haven, CT 06473-3149 | 2017-10-22 |
| 1376054148 | Joann Flynn LLC. | Clinic/Center | 3 Swanswood Ln, Old Lyme, CT 06371-1867 | 2017-10-19 |
| 1942723036 | Kellys Kids, Inc | Clinic/Center | 9 Spring Rd, Prospect, CT 06712-1522 | 2017-07-20 |
| 1295256840 | B.e.a.u.t.y, LLC | Clinic/Center | 824 Main St Ste F, Manchester, CT 06040-6048 | 2017-07-05 |
| 1518413442 | Community Partners In Action | Clinic/Center | 995 Sherman Ave, Hamden, CT 06514-1144 | 2016-08-31 |
| 1952760803 | Darbonshire, LLC | Clinic/Center | 304 Wahackme Rd, New Canaan, CT 06840-3936 | 2016-02-21 |
| 1760738025 | Psychologist Adriana L Gonzalez Phd Pllc | Clinic/Center | 85 Hillcrest Terrace, Meriden, CT 06450 | 2012-07-24 |
| 1497025035 | Ct Clinical Services, Inc. | Clinic/Center | 189 Orange St, New Haven, CT 06510-2014 | 2012-01-12 |
| 1093950032 | Yale Parenting and Child Conduct Clinic | Clinic/Center | 314 Prospect St, New Haven, CT 06511-2187 | 2008-12-04 |
| 1710185731 | Waterford Country School, Inc. | Clinic/Center | 78 Hunts Brook Rd, Quaker Hill, CT 06375-1009 | 2007-07-11 |
| Find all providers with the same taxonomy | ||||
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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.