Mindful Living, a Marriage and Family Therapy Corporation

Primary specialty

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

Legal business name

MINDFUL LIVING, A MARRIAGE AND FAMILY THERAPY CORPORATION

Practice address

200 Green St Ste 200
San Francisco, CA 94111-1356

Phone

(415) 890-3791

NPI assigned

Jun 3, 2020

Last updated

Jun 3, 2020By 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

Laurie Phuong Ertley, LMFTNPI 1144352279

Title

President

Phone

(415) 890-3791

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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.

• Laurie Phuong T Ertley, LMFT

  • Marriage & Family Therapist
  • San Francisco, CA
  • NPI 1144352279
  NPD Authorized official

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

{
    "created_epoch": "1591142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591142400000",
    "number": "1073137295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 GREEN ST STE 200",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941111356",
            "telephone_number": "415-890-3791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 GREEN ST STE 200",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941111356",
            "telephone_number": "415-890-3791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL LIVING, A MARRIAGE AND FAMILY THERAPY CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-03",
        "last_updated": "2020-06-03",
        "certification_date": "2020-06-03",
        "status": "A",
        "authorized_official_last_name": "ERTLEY",
        "authorized_official_first_name": "LAURIE PHUONG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "415-890-3791",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD BEHAVIORAL SERVICES",
            "identifier": "85042",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charisse Minatoya
• Katherine Laureana Minaya, MD
• Mind and Body Psychological Services, PC
• Trisha Kulkarni Mindel, A.S.W.
• Mindful Health Solutions a Professional Medical Corporation (TMS Health Solutions)
• Mindful Mental Wellness, P.a.
• Mindfulsf Marriage and Family Therapy Inc. (mindfulSF)
• Sean Ace Minerales
• Rita Angelina Minero, MSW
• Jacob Thomas Ming, D.D.S.

• Mental Health Clinic/Center (Including Community Mental Health Center) in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2020; 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.