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Mindful Matters LLC

Organization Active NPI Mental Health Counselor · Little Chute, WI

NPI 1124480744 · NPPES record last updated Mar 23, 2016

Key facts

NPI
1124480744
Entity type
Organization (NPI type 2)
Primary specialty
Mental Health Counselor 101YM0800X
License
4647-125 (WI)
Legal business name
MINDFUL MATTERS LLC
Practice address
528 Pine St Ste B
Little Chute, WI 54140-1812
Phone
(920) 209-0604
Fax
(920) 415-6090
NPI assigned
Mar 23, 2016
Organization subpart
No

Authorized official

Name
Mrs. Amy Lynn Vanden Heuvel, LPC
Title
Owner/Therapist
Phone
(920) 209-0604

Corporate family (same tax ID) 1

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

Practitioners 4

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

National Provider Directory

Tax ID family
Mindful Matters (2 organizations share this tax ID)

Locations

528 Pine St
Ste B
Little Chute, WI 54140
Phone (920) 209-0604

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor
Group: 193400000X SINGLE SPECIALTY GROUP		 101YM0800X 4647-125 WI Yes

Addresses

Primary practice location

528 Pine St Ste B
Little Chute, WI 54140-1812

Mailing address

528 Pine St Ste B
Little Chute, WI 54140-1812
Phone (920) 209-0604

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 23, 2016.

{
    "created_epoch": "1458691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458691200000",
    "number": "1124480744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "528 PINE ST STE B",
            "city": "LITTLE CHUTE",
            "state": "WI",
            "postal_code": "541401812",
            "telephone_number": "920-209-0604",
            "fax_number": "920-415-6090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "528 PINE ST STE B",
            "city": "LITTLE CHUTE",
            "state": "WI",
            "postal_code": "541401812",
            "telephone_number": "920-209-0604",
            "fax_number": "920-415-6090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL MATTERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-23",
        "last_updated": "2016-03-23",
        "status": "A",
        "authorized_official_last_name": "VANDEN HEUVEL",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "920-209-0604",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "4647-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Chute, WI

All providers in Little Chute, WI · Mental Health Counselor in Wisconsin

Sources for this page

Verify at the official NPI Registry.