Mind Well Psychological Services, PC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY25255 Issued in CA

Legal business name

MIND WELL PSYCHOLOGICAL SERVICES, PC

Practice address

648 Avenue B
Redondo Beach, CA 90277-4829

Phone

(708) 466-6443

NPI assigned

Nov 4, 2013

Last updated

Nov 4, 2013By 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

Dr. Lori Q Chaib, PSY.D.NPI 1952565079

Title

Director

Phone

(708) 466-6443

Specialties & licenses 1

Addresses

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.

• Lori Q Chaib, PSY.D.

  • Clinical Psychologist
  • Redondo Beach, CA
  • NPI 1952565079
  NPD (past) Authorized official

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

{
    "created_epoch": "1383523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383523200000",
    "number": "1053740746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "648 AVENUE B",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902774829",
            "telephone_number": "708-466-6443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "648 AVENUE B",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902774829",
            "telephone_number": "708-466-6443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND WELL PSYCHOLOGICAL SERVICES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-04",
        "last_updated": "2013-11-04",
        "status": "A",
        "authorized_official_last_name": "CHAIB",
        "authorized_official_first_name": "LORI",
        "authorized_official_middle_name": "Q",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "708-466-6443",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY25255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Miguel Torres, Licensed Clinical Social Worker, Apc (Calmar Wellness)
• Scott Mikolaycik
• Ronald Milestone, M.D.
• Corinna Lorraine Miller, RN
• Suzanne Lee Millican, LMFT
• Mindful Weight Loss
• Mineset Mental Health Inc.
• Faith Anne Mitchell, MFT
• Paulina Mae Mitchell
• Nasrin Moghadasian, D.C., F.I.C.P.A

• Clinical Psychologist in Redondo Beach, CA
• Providers in Redondo Beach, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2013; 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.