Mindful Restoration Services LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

MINDFUL RESTORATION SERVICES LLC

Doing business as

Mindful Restoration Counseling

Practice address

4465 N Oakland Ave Unit 310
Shorewood, WI 53211-1662

Phone

(414) 939-6540

Fax

(262) 946-0346

NPI assigned

Feb 24, 2021

Organization subpart

No

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

Authorized official

Name

Michele Donalson, LPCNPI 1336571512

Title

Owner, Counselor

Phone

(414) 939-6540

Specialties & licenses 2

Addresses

Other names 1

• Mindful Restoration Counseling Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michele Donalson, LPC

  • Professional Counselor
  • Shorewood, WI
  • NPI 1336571512
  NPD Authorized official

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

{
    "created_epoch": "1614124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718064000000",
    "number": "1184218737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13601",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532130601",
            "telephone_number": "414-939-6540",
            "fax_number": "262-946-0346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4465 N OAKLAND AVE UNIT 310",
            "city": "SHOREWOOD",
            "state": "WI",
            "postal_code": "532111662",
            "telephone_number": "414-939-6540",
            "fax_number": "262-946-0346"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 W Silver Spring Dr Ste K200",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "WI",
            "postal_code": "532175052",
            "country_code": "US",
            "telephone_number": "414-939-6540",
            "fax_number": "262-946-0346",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MINDFUL RESTORATION SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-24",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A",
        "authorized_official_last_name": "DONALSON",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_title_or_position": "OWNER, COUNSELOR",
        "authorized_official_telephone_number": "414-939-6540",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mindful Restoration Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Professional Counselor in Shorewood, WI
• Providers in Shorewood, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2024; 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.