Organization Active NPI

Mindful Synergy

  • Clinical Social Worker
  • Detroit, MI
National Provider Identifier
1013583632
Registry record updated Apr 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
MINDFUL SYNERGY
Practice address
19120 Grand River Ave
Detroit, MI 48223
Phone
(313) 999-3659
NPI assigned
Jun 3, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2026

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

Authorized official

Name
Dr. Irena J Glover, PHD, LMSWNPI 1518323021
Title
Therapist/Owner
Phone
(313) 608-9512

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

19120 Grand River Ave
Detroit, MI 48223

Mailing address

18701 Grand River Ave # 243
Detroit, MI 48223-2214
Phone (313) 999-3659

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251121000992 MI Part B Supplier - Clinic/Group Practice 6204328800 Receives reassigned benefits from 1 practitioner
Practice locations: Detroit, MI

National Provider Directory

National Provider Directory

Locations

3011 W Grand Blvd
Ste 1507
Detroit, MI 48202
Phone (313) 364-9775

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1622678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776643200000",
    "number": "1013583632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18701 GRAND RIVER AVE # 243",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482232214",
            "telephone_number": "313-999-3659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19120 GRAND RIVER AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48223",
            "telephone_number": "313-999-3659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL SYNERGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-03",
        "last_updated": "2026-04-20",
        "certification_date": "2026-04-20",
        "status": "A",
        "authorized_official_last_name": "GLOVER",
        "authorized_official_first_name": "IRENA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "THERAPIST/OWNER",
        "authorized_official_telephone_number": "313-608-9512",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, LMSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2026; 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.