Mindful Life Practice, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801092522 Issued in MI

Legal business name

MINDFUL LIFE PRACTICE, LLC

Practice address

221 Garland St
Traverse City, MI 49684-2372

Phone

(231) 486-0805

NPI assigned

Oct 7, 2015

Organization subpart

No

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

Authorized official

Name

Linda Smith, LMSWNPI 1407154719

Title

Partner

Phone

(231) 486-0805

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 4

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

• Linda Smith, LMSW

  • Clinical Social Worker
  • Traverse City, MI
  • NPI 1407154719
  Medicare reassignment NPD Authorized official
• Stephanie D Berger, LMSW

  • Social Worker
  • Traverse City, MI
  • NPI 1336420108
  Medicare reassignment NPD
• Paula Ann Kilcherman, LMSW

  • Clinical Social Worker
  • Traverse City, MI
  • NPI 1982072245
  Medicare reassignment NPD
• Susan Kirt, LMSW

  • Clinical Social Worker
  • Traverse City, MI
  • NPI 1962826982
  Medicare reassignment NPD

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

{
    "created_epoch": "1444176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737072000000",
    "number": "1053781765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 GARLAND ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842372",
            "telephone_number": "231-486-0805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 GARLAND ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842372",
            "telephone_number": "231-486-0805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL LIFE PRACTICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-07",
        "last_updated": "2025-01-17",
        "certification_date": "2025-01-17",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "231-486-0805",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401009566",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801093556",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801092522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindy A Mills
• Samantha Mills
• Sarah L Mills, D.O
• Ned Patrick Milne, RPH
• Alenn Dave Verzosa Mina, PHARMD
• Mindful Performance Therapy, PLLC
• Mindset Physical Therapy LLC
• Mindspot Counseling, PLLC
• Lora Lee Minidis, LPC
• Laura Lynne Minnis, LPN

• Clinical Social Worker in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2025; 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.