Mindful Addiction Recovery Service Inc

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

MINDFUL ADDICTION RECOVERY SERVICE INC

Practice address

101 Buford Rd Ste 203
North Chesterfield, VA 23235-5292

Phone

(804) 716-0005

NPI assigned

Aug 2, 2023

Organization subpart

No

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

Authorized official

Name

Mr. Donovan Gordon

Title

Ceo

Phone

(804) 551-8436

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1690934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690934400000",
    "number": "1144902925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 BUFORD RD STE 203",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232355292",
            "telephone_number": "804-551-8436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BUFORD RD STE 203",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232355292",
            "telephone_number": "804-716-0005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL ADDICTION RECOVERY SERVICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-02",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "DONOVAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "804-551-8436",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2023; 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.