Modern Mind Therapy & Life Coaching LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

MODERN MIND THERAPY & LIFE COACHING LLC

Practice address

4601 Fairfax Dr Ste 1200
Arlington, VA 22203-1559

Phone

(757) 303-7808

NPI assigned

Mar 28, 2021

Last updated

Apr 5, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lakeisha Grayer, LPCNPI 1467077651

Title

Owner

Phone

(757) 303-7808

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Modern Mind Therapy & Life Coaching LLC Former legal business name

Electronic endpoints 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lakeisha Grayer, LPC

  • Professional Counselor
  • Reston, VA
  • NPI 1467077651
  Authorized official Same address or phone

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

{
    "created_epoch": "1616889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617580800000",
    "number": "1003493610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13645 LEGACY CIR APT A",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201715265",
            "telephone_number": "175-730-3780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 FAIRFAX DR STE 1200",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222031559",
            "telephone_number": "757-303-7808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN MIND THERAPY & LIFE COACHING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-28",
        "last_updated": "2021-04-05",
        "certification_date": "2021-04-05",
        "status": "A",
        "authorized_official_last_name": "GRAYER",
        "authorized_official_first_name": "LAKEISHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "757-303-7808",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1467077651",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "contact@modernmind.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4601 Fairfax Dr Ste 1200",
            "city": "Arlington",
            "state": "VA",
            "country_code": "US",
            "postal_code": "222031559",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Modern Mind Therapy & Life Coaching LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Albert Mitchell III
• Ashley Shanta Mitchell, LCSW
• Tiffany Monique Mitchell
• Mobility Spa LLC (Emerald Massage Center)
• Rohit M. Modak, M.D.
• Moements, PLLC
• Nargess Moghaddam Maragheh, LPC
• Gabriel Ibrahim Mohammed Jr.
• Rihana Abdella Mohammed
• Alisabeth Mohr

• Professional Counselor in Arlington, VA
• Providers in Arlington, VA by specialty
• Professional Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.