Mind Body Therapy, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

MIND BODY THERAPY, LLC

Practice address

123 N Tyler Rd Ste 300
Wichita, KS 67212-3726

Phone

(316) 869-2230

NPI assigned

Mar 8, 2021

Last updated

Mar 16, 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

Nikki M Dennis

Title

Credentialing Agent

Phone

(316) 308-8273

Specialties & licenses 1

Addresses

Other names 2

• Pamela Beranek Other name
• Pamela Tinoco-Carreon Other name

Locations

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

{
    "created_epoch": "1615161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615852800000",
    "number": "1033704382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 N TYLER RD STE 300",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672123726",
            "telephone_number": "316-869-2230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 N TYLER RD STE 300",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672123726",
            "telephone_number": "316-869-2230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND BODY THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-08",
        "last_updated": "2021-03-16",
        "certification_date": "2021-03-16",
        "status": "A",
        "authorized_official_last_name": "DENNIS",
        "authorized_official_first_name": "NIKKI",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CREDENTIALING AGENT",
        "authorized_official_telephone_number": "316-308-8273"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pamela Beranek",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Pamela Tinoco-Carreon",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Tonk Mills, D.D.S.
• Veronicia S Mills
• Eleanor G Millsap, ARNP
• Sarah Milne, RN
• Teolinda Milsap, MD
• Mindbridge Therapy, LLC
• Mindclub Behavioral Health Kansas PA
• Mindful Care LLC
• Mindful Medicine LLC
• Mindful Mental Wellness, P.a.

• Clinical Social Worker in Wichita, KS
• Providers in Wichita, KS by specialty
• Clinical Social Worker in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 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.