NPIMap

Organization Active NPI

Mind Body Therapeutics LLC

  • Clinical Social Worker
  • Lake Worth, FL
National Provider Identifier
1093336505
Registry record updated Apr 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
MIND BODY THERAPEUTICS LLC
Practice address
8461 Lake Worth Rd BLDG 1
Lake Worth, FL 33467-2474
Phone
(772) 486-4417
NPI assigned
May 6, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2026

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

Authorized official

Name
Kimberly Carrion Alicea, PSYDNPI 1720578719
Title
Clinical Psychologist
Phone
(772) 486-4417

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 8

Specialty (taxonomy)CodeLicenseStatePrimary
Pastoral CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP1600X
Addiction (Substance Use Disorder) PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TA0400X
Adult Development & Aging PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TA0700X
Cognitive & Behavioral PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TB0200X
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X
Counseling PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC1900X
Health PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TH0004X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

8461 Lake Worth Rd BLDG 1
Lake Worth, FL 33467-2474

Mailing address

5156 NW 26TH Cir
Boca Raton, FL 33496-2210
Phone (561) 866-0217

Other practice location 1

2630 SE Willoughby Blvd Ste 2B
Stuart, FL 34994-4700
Phone (772) 486-4417

Other names 1

  • Center for the Healing Arts Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200605000524 FL Part B Supplier - Clinic/Group Practice 2769803485 Receives reassigned benefits from 5 practitioners
Practice locations: Lake Worth, FL; Stuart, FL

National Provider Directory

National Provider Directory

Locations

8461 Lake Worth Rd
Bldg 1
Lake Worth, FL 33467
Phone (772) 486-4417

2630 SE Willoughby Blvd
#2B
Stuart, FL 34994
Phone (772) 486-4417

2630 SE Willoughby Blvd
Ste 2B
Stuart, FL 34994
Phone (772) 486-4417

Practitioners & affiliated clinicians

Practitioners 7

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": "1588723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776297600000",
    "number": "1093336505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5156 NW 26TH CIR",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334962210",
            "telephone_number": "561-866-0217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8461 LAKE WORTH RD BLDG 1",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334672474",
            "telephone_number": "772-486-4417"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2630 SE Willoughby Blvd Ste 2B",
            "address_purpose": "LOCATION",
            "city": "Stuart",
            "state": "FL",
            "postal_code": "349944700",
            "country_code": "US",
            "telephone_number": "772-486-4417",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MIND BODY THERAPEUTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-06",
        "last_updated": "2026-04-16",
        "certification_date": "2026-04-16",
        "status": "A",
        "authorized_official_last_name": "CARRION ALICEA",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "772-486-4417",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "101YP1600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Pastoral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Adult Development & Aging",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, 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": [
        {
            "organization_name": "Center for the Healing Arts",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lake Worth, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.