NPIMap

Organization Active NPI

Mindful Balance Therapy Center P.L.L.C

  • Marriage & Family Therapist
  • Keene, NH
National Provider Identifier
1124423975
Registry record updated Nov 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Legal business name
MINDFUL BALANCE THERAPY CENTER P.L.L.C
Practice address
63 Emerald St # 102
Keene, NH 03431-3626
Phone
(603) 903-1414
Fax
(833) 693-0222
NPI assigned
Oct 22, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2020

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

Authorized official

Name
Allison Violet Carey, LMFTNPI 1306132519
Title
Manager
Phone
(603) 903-1414

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X Primary

Addresses

Primary practice location

63 Emerald St # 102
Keene, NH 03431-3626

Mailing address

63 Emerald St # 102
Keene, NH 03431-3626
Phone (603) 903-1414

Other identifiers 1

IdentifierTypeStateIssuer
3100005MedicaidNH

National Provider Directory

National Provider Directory

Locations

63 Emerald St
Keene, NH 03431
Phone (401) 216-5243

441 Main St
Keene, NH 03431
Phone (603) 357-3565

Practitioners & affiliated clinicians

Practitioners 10

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": "1413936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604880000000",
    "number": "1124423975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 EMERALD ST # 102",
            "city": "KEENE",
            "state": "NH",
            "postal_code": "034313626",
            "telephone_number": "603-903-1414",
            "fax_number": "833-693-0222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 EMERALD ST # 102",
            "city": "KEENE",
            "state": "NH",
            "postal_code": "034313626",
            "telephone_number": "603-903-1414",
            "fax_number": "833-693-0222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL BALANCE THERAPY CENTER P.L.L.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-22",
        "last_updated": "2020-11-09",
        "certification_date": "2020-10-16",
        "status": "A",
        "authorized_official_last_name": "CAREY",
        "authorized_official_first_name": "ALLISON",
        "authorized_official_middle_name": "VIOLET",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "603-903-1414",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3100005",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Keene, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 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.