NPIMap

Organization Active NPI

Mindfully Texas LLC

  • Mental Health Counselor
  • Austin, TX
National Provider Identifier
1104755008
Registry record updated May 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
MINDFULLY TEXAS LLC
Practice address
8500 Shoal Creek Blvd Ste 4-202a
Austin, TX 78757-7591
Phone
(737) 257-0829
Fax
(800) 583-9889
NPI assigned
May 16, 2026
Last updated
May 16, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
MINDFULLY TEXAS LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 16, 2026

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

Authorized official

Name
Tiffany Tait-Moss
Title
SVP
Phone
(954) 380-1507

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X

Addresses

Primary practice location

8500 Shoal Creek Blvd Ste 4-202a
Austin, TX 78757-7591

Mailing address

10290 Alliance Rd
Blue Ash, OH 45242-4710
Phone (737) 257-0829

National Provider Directory

National Provider Directory
Tax ID family
Mindfully Texas LLC5 organizations share this tax ID, including this one
Part of
Mindfully Texas LLC

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

8500 Shoal Creek Blvd
Ste 4202A
Austin, TX 78757
Phone (737) 257-0829

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1778889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778889600000",
    "number": "1104755008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10290 ALLIANCE RD",
            "city": "BLUE ASH",
            "state": "OH",
            "postal_code": "452424710",
            "telephone_number": "737-257-0829",
            "fax_number": "800-853-9889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8500 SHOAL CREEK BLVD STE 4-202A",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787577591",
            "telephone_number": "737-257-0829",
            "fax_number": "800-583-9889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFULLY TEXAS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MINDFULLY TEXAS LLC",
        "enumeration_date": "2026-05-16",
        "last_updated": "2026-05-16",
        "certification_date": "2026-05-16",
        "status": "A",
        "authorized_official_last_name": "TAIT-MOSS",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_title_or_position": "SVP",
        "authorized_official_telephone_number": "954-380-1507"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2026; 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.