Organization Active NPI

Mindful Healing Group

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • New York, NY
National Provider Identifier
1154191328
Registry record updated Jun 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
MINDFUL HEALING GROUP
Practice address
136 Madison Ave
New York, NY 10016-6711
Phone
(910) 818-4957
Fax
(910) 500-5238
NPI assigned
Jan 8, 2024
Last updated
Jun 13, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2025

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

Authorized official

Name
Jerry Bell Cunningham Jr.
Title
Coo
Phone
(910) 209-4122

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

136 Madison Ave
New York, NY 10016-6711

Mailing address

5000 Centre Green Way Ste 500
Cary, NC 27513-5821
Phone (910) 302-6740

Other names 1

  • Mindful Healing LLC Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251119003663 NC Part B Supplier - Clinic/Group Practice 3971030388 Receives reassigned benefits from 2 practitioners
Practice locations: Raleigh, NC

National Provider Directory

National Provider Directory

Locations

8506 Six Forks Rd
Ste 202
Raleigh, NC 27615
Phone (919) 297-2762

Practitioners & affiliated clinicians

Practitioners 2

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": "1704672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749772800000",
    "number": "1154191328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 CENTRE GREEN WAY STE 500",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275135821",
            "telephone_number": "910-302-6740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 MADISON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166711",
            "telephone_number": "910-818-4957",
            "fax_number": "910-500-5238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL HEALING GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-08",
        "last_updated": "2025-06-13",
        "certification_date": "2025-06-13",
        "status": "A",
        "authorized_official_last_name": "CUNNINGHAM",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "BELL",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "910-209-4122",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mindful Healing LLC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Mindful Healing LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.