Mindful Awakenings, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

5355 Issued in OR

Legal business name

MINDFUL AWAKENINGS, LLC

Practice address

4511 SE Hawthorne Blvd
Suite 204
Portland, OR 97215-3182

Phone

(503) 706-8413

NPI assigned

Mar 1, 2017

Organization subpart

No

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

Authorized official

Name

Miss Ryann Mishell Moore, LCSWNPI 1932439650

Title

Manager/Owner

Phone

(503) 706-8413

Specialties & licenses 1

Addresses

Practitioners 1

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

• Ryann Mishell Moore, LCSW

  • Clinical Social Worker
  • Portland, OR
  • NPI 1932439650
  NPD (past) Authorized official

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

{
    "created_epoch": "1488326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488326400000",
    "number": "1083154637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4324 NE 57TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972182241",
            "telephone_number": "912-381-5898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4511 SE HAWTHORNE BLVD",
            "address_2": "SUITE 204",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972153182",
            "telephone_number": "503-706-8413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL AWAKENINGS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-01",
        "last_updated": "2017-03-01",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "RYANN",
        "authorized_official_middle_name": "MISHELL",
        "authorized_official_title_or_position": "MANAGER/OWNER",
        "authorized_official_telephone_number": "503-706-8413",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "OR",
            "license": "5355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mind Body Spirit LLC (Mind Body Spirit - A Holistic Community)
• Mind Body Therapy
• Mind Body Therapy
• Mind Body Therapy Center, LLC
• Mind Solutions LLC
• Mindful Growth and Wellness LLC (Emily DeMarco, MD)
• Mindful Health Northwest LLC
• Mindful Kinetics LLC
• Mindful Medicine, PC
• Mindful Mental and Behavioral Health PLLC

• Community/Behavioral Health Agency in Portland, OR
• Providers in Portland, OR by specialty
• Community/Behavioral Health Agency in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 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.