Active NPI
Mindful Clinical Services, LLC
- Clinical Social Worker
- Los Angeles, CA
National Provider Identifier
1174265383
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Legal business name
- MINDFUL CLINICAL SERVICES, LLC
- Practice address
- 1923 1/2 Westwood Blvd, Suite 4
Los Angeles, CA 90025 - Phone
- (747) 228-2621
- NPI assigned
- Apr 8, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Samantha Wright Wakach, LCSW
- Title
- Co-Founder, Mindful Clinical Servic
- Phone
- (747) 228-2621
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | Primary | ||
| Marriage & Family Therapist | 106H00000X |
Addresses
Primary practice location
1923 1/2 Westwood Blvd, Suite 4
Los Angeles, CA 90025
Mailing address
1923 1/2 Westwood Blvd, Suite 4
Los Angeles, CA 90025
Phone (747) 228-2621
National Provider Directory
National Provider Directory- Tax ID family
- Mindful Clinical Services LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Clinical Social Worker
- Los Angeles, CA
- NPI 1548901317
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Clinical Social Worker
- Los Angeles, CA
- NPI 1720126832
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1649376000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1649376000000",
"number": "1174265383",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1923 1/2 WESTWOOD BLVD, SUITE 4",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90025",
"telephone_number": "747-228-2621"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1923 1/2 WESTWOOD BLVD, SUITE 4",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90025",
"telephone_number": "747-228-2621"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MINDFUL CLINICAL SERVICES, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-04-08",
"last_updated": "2022-04-08",
"certification_date": "2022-04-07",
"status": "A",
"authorized_official_last_name": "WAKACH",
"authorized_official_first_name": "SAMANTHA",
"authorized_official_middle_name": "WRIGHT",
"authorized_official_title_or_position": "CO-FOUNDER, MINDFUL CLINICAL SERVIC",
"authorized_official_telephone_number": "747-228-2621",
"authorized_official_name_prefix": "Ms.",
"authorized_official_credential": "LCSW"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
},
{
"code": "106H00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Marriage & Family Therapist",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.