NPIMap

Organization Active NPI

Mind, Body & Soul

  • Mental Health Counselor
  • Houston, TX
National Provider Identifier
1063728251
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
MIND, BODY & SOUL
Practice address
1400 Broadfield Blvd Ste 200
Houston, TX 77084-5162
Phone
(281) 906-7134
Fax
(281) 612-1160
NPI assigned
Aug 25, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Authorized official

Name
Tameka Nichole BirtsNPI 1508211079
Title
Chief Operating Officer
Phone
(770) 873-0087

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 5

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X
Case Management Agency 251B00000X
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

1400 Broadfield Blvd Ste 200
Houston, TX 77084-5162

Mailing address

1400 Broadfield Blvd,
Suite 200
Houston, TX 77084-5162
Phone (281) 906-7134

Other practice location 1

4449 Covington Hwy
Decatur, GA 30035-1214
Phone (770) 873-0087

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.

NPI Registry JSON

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

{
    "created_epoch": "1282694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1063728251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 BROADFIELD BLVD,",
            "address_2": "SUITE 200",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770845162",
            "telephone_number": "281-906-7134",
            "fax_number": "281-612-1160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 BROADFIELD BLVD STE 200",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770845162",
            "telephone_number": "281-906-7134",
            "fax_number": "281-612-1160"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4449 Covington Hwy",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "GA",
            "postal_code": "300351214",
            "country_code": "US",
            "telephone_number": "770-873-0087",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MIND, BODY & SOUL",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-25",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "BIRTS",
        "authorized_official_first_name": "TAMEKA",
        "authorized_official_middle_name": "NICHOLE",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "770-873-0087"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.