Awakened Mind, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

MH11538 Issued in FL

Legal business name

AWAKENED MIND, LLC

Practice address

7401 Wiles Road
Suite 253
Coral Springs, FL 33067

Phone

(561) 420-4031

Fax

(954) 827-0297

NPI assigned

Jul 21, 2016

Last updated

Jul 21, 2016By 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

Ilene Joy Glance, LMHC, NCC, CCMHC

Title

Owner/Therapist

Phone

(561) 420-4031

Specialties & licenses 1

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.

• Meredith Lee Chadeayne, LCSW

  • Clinical Social Worker
  • Coral Springs, FL
  • NPI 1285097642
  NPD (past)

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

{
    "created_epoch": "1469059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469059200000",
    "number": "1174976435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7401 WILES ROAD",
            "address_2": "SUITE 253",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "33067",
            "telephone_number": "561-420-4031",
            "fax_number": "954-827-0297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7401 WILES ROAD",
            "address_2": "SUITE 253",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "33067",
            "telephone_number": "561-420-4031",
            "fax_number": "954-827-0297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AWAKENED MIND, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-21",
        "last_updated": "2016-07-21",
        "status": "A",
        "authorized_official_last_name": "GLANCE",
        "authorized_official_first_name": "ILENE",
        "authorized_official_middle_name": "JOY",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "561-420-4031",
        "authorized_official_credential": "LMHC, NCC, CCMHC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "FL",
            "license": "MH11538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Avante Garde Management Group PLLC (Coral Springs Dental Care)
• Philip Fred Averbuch, MD
• Constance Avery-Clark, PH.D.
• Angie Q Aviles, L.M.T.
• Silvio Xavier Avilez Cerna, MD
• Maria Ayala-Amisial
• Gloria Ayala-St.Charles, LMHC
• Sunil Ayyagari, MD
• Sara Maria Aza, D.D.S.
• Mazieyar Azad, MD

• Community/Behavioral Health Agency in Coral Springs, FL
• Providers in Coral Springs, FL by specialty
• Community/Behavioral Health Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2016; 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.