Mosaic Leaf Therapy and Wellness, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

071.009800 Issued in IL

Legal business name

MOSAIC LEAF THERAPY AND WELLNESS, LLC

Practice address

200 W Madison St Ste 2100
Chicago, IL 60606

Phone

(312) 522-8280

NPI assigned

Aug 9, 2018

Last updated

Sep 6, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Theressa L Labarrie Mitchell, PHDNPI 1356791917

Title

Clinical Psychologist and Founder

Phone

(312) 522-8280

Specialties & licenses 3

Addresses

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.

• Theressa L. Labarrie Mitchell, PHD

  • Clinical Psychologist
  • Chicago, IL
  • NPI 1356791917
  Authorized official Same address or phone

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

{
    "created_epoch": "1533772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536192000000",
    "number": "1174002356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W MADISON ST STE 2100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606063521",
            "telephone_number": "312-522-8280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W MADISON ST STE 2100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60606",
            "telephone_number": "312-522-8280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOSAIC LEAF THERAPY AND WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-09",
        "last_updated": "2018-09-06",
        "status": "A",
        "authorized_official_last_name": "LABARRIE MITCHELL",
        "authorized_official_first_name": "THERESSA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST AND FOUNDER",
        "authorized_official_telephone_number": "312-522-8280",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "IL",
            "license": "071.009800",
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "IL",
            "license": "071.009800",
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "IL",
            "license": "071.009800",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Elena Morud, DNP
• Morvarid Sadri DDS PC (Sadri's Family Dental)
• Amy Morvay, LCPC
• Mosaic Childhood Project, Inc.
• Mosaic Childhood Project, Inc.
• Kendall R Mosby-Thompson
• Maria Caroline Moscati Weiss
• Molly Sandeep Moschovas, DC
• Sotiria E. Moschovis, M.D.
• Moscoso S.C. (Sylvia Moscoso MD)

• Mental Health Clinic/Center (Including Community Mental Health Center) in Chicago, IL
• Providers in Chicago, IL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2018; 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.