Organization Active NPI

Mindful Intentions LCSW Psychotherapy PLLC

  • Clinical Social Worker
  • Forest Hills, NY
National Provider Identifier
1063278471
Registry record updated Aug 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
MINDFUL INTENTIONS LCSW PSYCHOTHERAPY PLLC
Practice address
7211 Austin St Ste 102
Forest Hills, NY 11375-5354
Phone
(267) 225-8763
NPI assigned
Feb 23, 2024
Last updated
Aug 6, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2025

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

Authorized official

Name
Christy Bush, LCSWNPI 1487219598
Title
Owner
Phone
(267) 225-8763

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

7211 Austin St Ste 102
Forest Hills, NY 11375-5354

Mailing address

7211 Austin St Ste 102
Forest Hills, NY 11375-5354
Phone (631) 871-3675

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1708646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754438400000",
    "number": "1063278471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7211 AUSTIN ST STE 102",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113755354",
            "telephone_number": "631-871-3675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7211 AUSTIN ST STE 102",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113755354",
            "telephone_number": "267-225-8763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL INTENTIONS LCSW PSYCHOTHERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-23",
        "last_updated": "2025-08-06",
        "certification_date": "2025-08-04",
        "status": "A",
        "authorized_official_last_name": "BUSH",
        "authorized_official_first_name": "CHRISTY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "267-225-8763",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2025; 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.