NPIMap

Organization Active NPI

Mindful Matters LLC

  • Mental Health Counselor
  • Little Chute, WI
National Provider Identifier
1124480744
Registry record updated Mar 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
4647-125 Issued in 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
Last updated
Mar 23, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2016

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X 4647-125 WI Primary

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

National Provider Directory

National Provider Directory
Tax ID family
Mindful Matters2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "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

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2016; 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.