Organization Active NPI

Mindful Healing Inc.

  • Clinical Social Worker
  • Roanoke, VA
National Provider Identifier
1174984348
Registry record updated Apr 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904008116 Issued in VA
Legal business name
MINDFUL HEALING INC.
Practice address
3618 Brambleton Ave Ste C
Roanoke, VA 24018-3659
Phone
(540) 521-0151
Fax
(540) 655-4199
NPI assigned
Mar 15, 2016
Last updated
Apr 24, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2024

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

Authorized official

Name
Karen Forbes, LCSWNPI 1407192271
Title
Owner
Phone
(540) 353-4015

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)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X
Clinical Social Worker 1041C0700X 0904008116 VA Primary

Addresses

Primary practice location

3618 Brambleton Ave Ste C
Roanoke, VA 24018-3659

Mailing address

3618 Brambleton Ave Ste C
Roanoke, VA 24018-3659
Phone (540) 353-4015

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170605002211 VA Part B Supplier - Clinic/Group Practice 3274800750 Receives reassigned benefits from 2 practitioners
Practice locations: Roanoke, VA

National Provider Directory

National Provider Directory

Locations

3536 Brambleton Ave
Ste 7
Roanoke, VA 24018
Phone (540) 353-4015

Practitioners & affiliated clinicians

Practitioners 7

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": "1458000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713916800000",
    "number": "1174984348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3618 BRAMBLETON AVE STE C",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240183659",
            "telephone_number": "540-353-4015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3618 BRAMBLETON AVE STE C",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240183659",
            "telephone_number": "540-521-0151",
            "fax_number": "540-655-4199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL HEALING INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-15",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A",
        "authorized_official_last_name": "FORBES",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "540-353-4015",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904008116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2024; 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.