Mindful Balance, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

7384-C Issued in NV

Legal business name

MINDFUL BALANCE, LLC

Practice address

4345 Hatch Bend Ave
North Las Vegas, NV 89031-4302

Phone

(702) 419-0311

NPI assigned

Apr 9, 2017

Organization subpart

No

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

Authorized official

Name

Linnetta R Cooley, LCSW

Title

Manager/Member

Phone

(702) 831-8282

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1491696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491696000000",
    "number": "1053844712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6655 W SAHARA AVE",
            "address_2": "SUITE B200",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891460842",
            "telephone_number": "702-831-8282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4345 HATCH BEND AVE",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890314302",
            "telephone_number": "702-419-0311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL BALANCE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-09",
        "last_updated": "2017-04-09",
        "status": "A",
        "authorized_official_last_name": "COOLEY",
        "authorized_official_first_name": "LINNETTA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "MANAGER/MEMBER",
        "authorized_official_telephone_number": "702-831-8282",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NV",
            "license": "7384-C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1730580168",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sandy Miller, LCSW
• Gloria Mills
• Lawrence Mills Jr.
• Eunyoung Min
• Seung Ki Min
• Mindsprout ABA LLC
• Nicole Miner
• Jacquesha Mingo
• Melinda Marie Minor, PERSONAL CAREGIVER
• Miracle Massage Day Spa

• Mental Health Clinic/Center (Including Community Mental Health Center) in North Las Vegas, NV
• Providers in North Las Vegas, NV by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2017; 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.