Integrated Mindsets Inc

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

INTEGRATED MINDSETS INC

Practice address

3860 Windermere Pkwy Ste 203
Cumming, GA 30041-7034

Phone

(770) 953-4744

NPI assigned

Sep 12, 2019

Organization subpart

No

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

Authorized official

Name

Maurisa Brodsky Versel, LPC

Title

Owner

Phone

(770) 953-4744

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Maurisa Brodsky Versel, LPC

  • Professional Counselor
  • Cumming, GA
  • NPI 1952954844
  NPD

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

{
    "created_epoch": "1568246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568246400000",
    "number": "1124678099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1827 POWERS FERRY RD SE BLDG 22",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303395621",
            "telephone_number": "770-953-4744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3860 WINDERMERE PKWY STE 203",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300417034",
            "telephone_number": "770-953-4744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED MINDSETS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-12",
        "last_updated": "2019-09-12",
        "status": "A",
        "authorized_official_last_name": "BRODSKY VERSEL",
        "authorized_official_first_name": "MAURISA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-953-4744",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "LPC003680",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Cumming, GA
• Providers in Cumming, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2019; 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.