Mind Centered Wellness LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC05302800 Issued in NJ

Legal business name

MIND CENTERED WELLNESS LLC

Practice address

147 Union Ave
2D
Middlesex, NJ 08846-1063

Phone

(908) 203-8122

NPI assigned

Jul 7, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Marie Gonzalez, LCSWNPI 1225113491

Title

Owner

Phone

(908) 203-8122

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Marie Theresa Gonzalez, LCSW

  • Clinical Social Worker
  • Branchburg, NJ
  • NPI 1225113491
  Medicare reassignment NPD Authorized official
• Anupama Saale-Prasad, PH.D.

  • Clinical Psychologist
  • Middlesex, NJ
  • NPI 1629215967
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1309996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329436800000",
    "number": "1003103300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 UNION AVE",
            "address_2": "2D",
            "city": "MIDDLESEX",
            "state": "NJ",
            "postal_code": "088461063",
            "telephone_number": "908-203-8122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 UNION AVE",
            "address_2": "2D",
            "city": "MIDDLESEX",
            "state": "NJ",
            "postal_code": "088461063",
            "telephone_number": "908-203-8122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND CENTERED WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-07",
        "last_updated": "2012-02-17",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "908-203-8122",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05302800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Middlesex Community Medicalcare, LLC
• Middlesex Family Dental
• Middlesex Medical Care PC
• Middlesex Public School District
• Justin Miller
• Norma A Moreno, LCSW
• David A. Morse, L.AC.
• Shara Moskowitz
• Eric A Myrick
• New B E S T Somerset P C

• Clinical Social Worker in Middlesex, NJ
• Providers in Middlesex, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.