MIND BODY SOUL - PSYCHOLOGY AND CONSULTING GROUP LLC (NPI# 1912434234) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912434234 |
| Entity Type | Organization |
| Organization Name | MIND BODY SOUL - PSYCHOLOGY AND CONSULTING GROUP LLC |
| Practice Address |
109 Danbury Road Lower Level, Suite D6 Ridgefield CT 06877-0687 |
| Mailing Address |
109 Danbury Road Lower Level, Suite D6 Ridgefield CT 06877 |
| Practice Telephone | 2034948468 |
| Practice Fax Number | 8455820764 |
| Mailing Telephone | 2034948468 |
| Mailing Fax Number | 8455820764 |
| Enumeration Date | 2017-05-17 |
| Last Update Date | 2018-03-17 |
| Authorized Official Name | DR. LORI WAGNER (OWNER, CLINICAL PSYCHOLOGIST) |
| Authorized Official Telephone | 2034948468 |
| Authorized Official Credential | PSYD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
2706 | CT | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 109 Danbury Rd Lowr Level, Ridgefield, CT 068774142 | (203) 494-8468 | 8455820764 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | Mind Body Soul - Psychology and Consulting Group LLC | 109 Danbury Rd Lower Level Suite D6, Ridgefield, CT 06877 |
| Street Address |
109 DANBURY ROAD LOWER LEVEL, SUITE D6 |
| City | RIDGEFIELD |
| State | CT |
| Zip Code | 06877-0687 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285902387 | Lori Wagner | Clinical Neuropsychologist | 109 Danbury Road, Lower Level, Suite D6, Ridgefield, CT 06877 | 2011-12-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639653850 | Kari Bradley Lombardo | Physical Therapist | 28 Fieldcrest Drive, Ridgefield, CT 06877 | 2018-09-24 |
| 1942710868 | Being Centered: Psycological Services, Pllc | Psychologist | 100b Danbury Rd., Ste 105e, Ridgefield, CT 06877 | 2017-10-05 |
| 1376996587 | Laura Susan Craighead | Social Worker | 90 Bloomer Rd, Ridgefield, CT 06877 | 2016-07-22 |
| 1760801161 | Haig Dodakian | Physician Assistant | 27 Jefferson Drive, Ridgefield, CT 06877 | 2014-04-14 |
| 1669895306 | Sharon Fudge Hoffner | Physical Therapist | 250 Ivy Hill Road, Ridgefield, CT 06877 | 2014-01-31 |
| 1720416910 | Lisa Oths | Counselor | 100 B Danbury Road, Suite 201a, Ridgefield, CT 06877 | 2013-10-24 |
| 1184059966 | Abigail Quincy Egginton | Naturopath | 100b Danbury Rd, Suite 102, Ridgefield, CT 06877 | 2013-09-11 |
| 1407110281 | Nicole Steen | Social Worker | 100b Danbury Road, Suite 201a, Ridgefield, CT 06877 | 2012-06-27 |
| 1023384328 | Kelley Hopkins-alvarez | Counselor | 100b Danbury Rd Suite 201d, Ridgefield, CT 06877 | 2012-03-30 |
| 1235437088 | Penelope Mcdonnell | Naturopath | 90 East Ridge Rd, Ridgefield, CT 06877 | 2011-03-03 |
| Find all providers in zip 06877 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063777068 | Nicole Gabriel, LLC | Psychologist | 6b Barry Ave, Ridgefield, CT 06877-4424 | 2012-07-06 |
| 1184951105 | Caley Schwartz | Psychologist | 137 Ethan Allen Hwy, Suite 1, Ridgefield, CT 06877-6238 | 2009-11-12 |
| 1922253210 | Maria Larino | Psychologist | 11 Kiahs Brook Ln, Ridgefield, CT 06877-1907 | 2008-12-01 |
| 1598915498 | Valentina Shehu | Psychologist | 46 Powderhorn Dr, Ridgefield, CT 06877-4201 | 2008-09-26 |
| 1841379112 | Stacy Ann Raymond | Psychologist | 100b Danbury Rd, Suite 101, Ridgefield, CT 06877-4110 | 2006-11-06 |
| 1215032024 | Joan W Whittemore | Psychologist | 80 Grove Street, Ridgefield, CT 06877 | 2006-09-14 |
| 1316963846 | Valerie Larkin | Psychologist | 898 Ethan Allen Hwy, Suite 7, Ridgefield, CT 06877-2813 | 2006-07-15 |
| 1245647965 | Elizabeth Courtney-seidler | Psychologist | 100b Danbury Road, Suite 105b, Ridgefield, CT 06877 | 2014-07-15 |
| 1225320856 | Barbara Keefe | Psychologist | 90 Grove St, Suite 206, Ridgefield, CT 06877-4114 | 2011-05-16 |
| 1790089126 | Saasha Sutera Hogan | Psychologist | 383 Main St, Ridgefield, CT 06877-4652 | 2010-12-28 |
| Find all providers in RIDGEFIELD | ||||
| City | RIDGEFIELD |
| Zip Code | 06877 |
Please comment or provide details below to improve the information on MIND BODY SOUL - PSYCHOLOGY AND CONSULTING GROUP LLC.
| 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.