NPIMap

Organization Active NPI

Mind, Body, and Spirit Through Therapy, LCC

  • Mental Health Counselor
  • Mount Laurel, NJ
National Provider Identifier
1083900153
Registry record updated Jun 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
37PC00395500 Issued in NJ
Legal business name
MIND, BODY, AND SPIRIT THROUGH THERAPY, LCC
Practice address
402 Birchfield Dr
Mount Laurel, NJ 08054-4007
Phone
(215) 499-3136
NPI assigned
Jun 27, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2011

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

Authorized official

Name
Ms. Nicole L Halushka, ED.S., NCC, LPC
Title
Licensed Psychotherapist
Phone
(215) 499-3136

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X 37PC00395500 NJ Primary

Addresses

Primary practice location

402 Birchfield Dr
Mount Laurel, NJ 08054-4007

Mailing address

402 Birchfield Dr
Mount Laurel, NJ 08054-4007
Phone (215) 499-3136

National Provider Directory

National Provider Directory

Locations

402 Birchfield Dr
Mount Laurel, NJ 08054
Phone (215) 499-3136

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": "1309132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309132800000",
    "number": "1083900153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 BIRCHFIELD DR",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080544007",
            "telephone_number": "215-499-3136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 BIRCHFIELD DR",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080544007",
            "telephone_number": "215-499-3136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND, BODY, AND SPIRIT THROUGH THERAPY, LCC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-27",
        "last_updated": "2011-06-27",
        "status": "A",
        "authorized_official_last_name": "HALUSHKA",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "LICENSED PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "215-499-3136",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "ED.S., NCC, LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "37PC00395500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Laurel, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2011; 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.