Mind Spa Inc

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

19695 Issued in TX

Legal business name

MIND SPA INC

Practice address

1801 N Hampton Rd Ste 410
Desoto, TX 75115-2338

Phone

(972) 780-5160

Fax

(972) 780-5735

NPI assigned

Jun 2, 2008

Organization subpart

No

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

Authorized official

Name

Prof. Larry Grover Washington, M.S.

Title

Licensed Professional Counselor

Phone

(972) 780-5160

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Solution Health and Rehab Other name

Locations

Practitioners 1

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.

• Candace M Stafford, PSYD

  • Clinical Psychologist
  • Richmond Hill, GA
  • NPI 1245261627
  NPD (past)

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

{
    "created_epoch": "1212364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331078400000",
    "number": "1154580538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 N HAMPTON RD STE 410",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751152338",
            "telephone_number": "972-780-5160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 N HAMPTON RD STE 410",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751152338",
            "telephone_number": "972-780-5160",
            "fax_number": "972-780-5735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND SPA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-02",
        "last_updated": "2012-03-07",
        "status": "A",
        "authorized_official_last_name": "WASHINGTON",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "GROVER",
        "authorized_official_title_or_position": "LICENSED PROFESSIONAL COUNSELOR",
        "authorized_official_telephone_number": "972-780-5160",
        "authorized_official_name_prefix": "Prof.",
        "authorized_official_credential": "M.S."
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Counseling",
            "state": "TX",
            "license": "19695",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "9017LC",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Solution Health and Rehab",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Ella Marie Miles, L.V.N.,B.B.A.
• Freddie L Miller Jr.
• Adrian Mills, CNM
• Milo's Health & Beauty, LLC
• Mind Renwal
• Mindful Thinking Matters PLLC
• Mint Dentistry, PLLC (Desoto Mint Dentistry)
• Naila Sarwat Mirza, M.D.
• Seneca Darnelle Mitchell-Creer, RDA X2
• Cassandra Latrice Mitchell, MA, LPC

• Counseling Psychologist in Desoto, TX
• Providers in Desoto, TX by specialty
• Counseling Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2012; 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.